Chula Vista City Council
January 25, 2022

From: Robin Madaffer < robin@sdlandlaw. com>
Sent: Friday, January 21, 2022 3: 04 PM
To: CityClerk < CityClerk@chulavistaca. gov>
Cc: Glen Googins < GGoogins@chulavistaca. gov>; Michael Shirey < MShirey@chulavistaca. gov>; Tiffany Allen < TAllen@chulavistaca. gov>; Laura Black < lblack@chulavistaca. gov>; Todd Philips Tphilips@chulavistaca. gov>; Stan Donn < Sdonn@chulavistaca. gov> Subject: Eastlake Behavioral Health Hospital - Appeal Response Letter to City Council - Hearing January 25, 2022 - Agenda Item 7.2
Importance: High
Please see attached appeal response letter for the Eastlake Behavioral Health Hospital.

Robin Madaffer, Esq.
1620 Fifth Avenue, Suite 400
San Diego, California 92101
Mobile ( 619) 985- 0940
Office ( 619) 239- 7603
robin@sdlandlaw. com
www. SDLandLaw. com | www. Madaffer. com
Warning:

External
Email
January21, 2022
MayorMaryCasillasSalasandMembersof theChulaVistaCityCouncil c/o CityClerkKerryK. Bigelow, MMC – VIAEMAIL - [email protected] 276FourthAvenue
ChulaVista, CA91910
MayorCasillasSalasandCityCouncilmembers,
Our firm representsEastlakeBehavioralHealth, LLC, (“EBH”), a joint venture betweenAcadiaSanDiegoJVHoldings, LLC (“Acadia”) and ScrippsBehavioralHealth Venture, LLC (“Scripps”). EBHis the applicantfor a conditionalusepermit to developa behavioralhealthhospitalonShowroomPlacein Eastlake, ChulaVista (“EastlakeHospital” or “Project”).

The project was originallysubmittedto the City in March 2019. It has been reviewedbythe City’sprofessionalstafffor nearlythreeyears. Duringthat time, EBHhas presentedthe projectto numerouscommunitystakeholdersandreceivedbroadsupport.

Theprojectwasapprovedby the City’s PlanningCommissionon November10, 2021. It comesbeforeyou becauseof an appealfiled by a projectopponent. Theappealwas originallyscheduledfor CityCouncilconsiderationon December7, 2021, consistentwith the City’sMunicipalCoderequirementthat it beheardwithin30daysof the appealfiling.

However, the appellantrequestedit be delayed. EBHagreedand the hearingwas rescheduledto January11, 2022. Priorto the rescheduledhearingdate, the appellant againrequestedanotherdelayandonceagainEBHagreedwiththeunderstandingit would goforwardonJanuary25, 2022, timecertainwith nofurtherdelays.

Theappealisbasedonfivegrounds, asstatedontheappealformasfollows:

1. FindingsNot Supported: TheReportdoesnot providesufficientsupportas requiredby CaliforniaPublicResourcesCode21100(b)(4) and21002.1(a). The reportfailsto describethealternativesthat werethoroughlyassessed.

2. FactualError: TheApplicantmaderepresentationsregardingeconomicimpact that werefactuallyin error.

3. NewInformation: ApplicanthadExpartecommunicationwith theCouncilthat wasnotdisclosedormadepublic.

4. FindingsNot Supported: TheApplicantpreparedtheEIRbut failedto address andanswercommunityquestionsandinput.

5. NewInformation: Applicantfailedto provideupdatedor completedisclosures.

Thisletterwill refuteeachof thesefiveappealissuesto supportdenyingtheappeal at yourCityCouncilmeetingonJanuary25, 2022. Beforediscussingeachof thefiveappeal issues, it isimportantto considersomethresholdmatters.

It is withoutquestionthat behavioralhealthissuesareat crisislevelsbothlocally andacrossthe country. Theyoften leadto catastrophicconsequencesfor families. The pandemichassignificantlyexacerbatedthe dire effectson communities, includingChula Vista. Asdescribedin the City’s staff report, both FederalandStatelawsarein placeto encourageandprotectfacilitiesthat provideservicesto patientsexperiencingbehavioral healthdisabilities. HereisaparaphrasedexcerptfromtheCity’sstaffreport:

Pursuantto the Americanswith DisabilitiesAct, disability discriminationis prohibitedin all activitiesof localgovernmententities, includingzoningdecisions.

This nondiscriminationmandate requiresthe City to provide equal services, programs, andactivitiesto entitiesthat serveindividualswith disabilitiesandto ensurethat theCity’szoningdecisionsdonotdiscriminateagainstindividualswith disabilitiesandentitiesassociatedwith them. TheCityis furtherprohibitedfrom utilizing criteria that have the effect of discriminatingagainstindividualswith disabilitiesor applyingeligibility criteria that screenout or tend to screenout individualswith disabilities.

Additionally, bothTitleII of theADAandtheFairHousingAmendmentsActof 1988 42 U.S.C. §3601) protectthe rights of both providersand clientsof residential treatment programsand prohibitsthe exclusionor otherwisedenial of equal services, programs, or activitiesto an individualor entity becauseof the known actualor perceived) disabilityof an individualwith whomthe individualor entity hasa knownrelationshipor association. See28C.F.R. 35.108(f)(1).

Thus, the law prohibitsthe Cityfrom applyingits zoningto discriminateagainst individualswithbehavioralhealthdisabilitiesandentitiesassociatedwiththem.

For all the reasonsstated in this letter, we urge you to follow City staff’s recommendationand supportthe CityPlanningCommission’s decisionto approvethe projectanddenytheappeal.

APPEALISSUE #1
FindingsNotSupported: TheReportdoesnotprovidesufficientsupportasrequiredby CaliforniaPublicResourcesCode21100(b)(4) and21002.1(a). Thereportfailsto describe thealternativesthat werethoroughlyassessed.

EBHRESPONSE:

CaliforniaPublicResourcesCode (“CEQA”) section21100(b)(4) states:

Theenvironmentalimpactreportshallincludea detailedstatement settingforthallof thefollowing:

Alternativesto theproposedproject.

FurtherCEQAsection21002.1(a) states:

Thepurposeof anenvironmentalimpactreportisto identifythe significanteffectsontheenvironmentof a project, to identifyalternatives to theproject, andto indicatethemannerin whichthosesignificanteffects canbemitigatedor avoided.

Thisappealissuefocuseson the projectalternativesevaluatedin the Environmental ImpactReportpreparedfor the Project (“EIR”). CEQArequiresevaluationof areasonable rangeof alternatives, includingaNoProjectalternative.

First, thecitydidnotrequireanEIRbeprepared, relyingontheexistingFinalEIRfor theSpecificPlanAreawhichconsideredwhatcouldbebuilt onthesite. Nevertheless, EBH choseto prepareanEIR, at significanttimeandexpense, in anticipationof oppositioneven thoughtherearenosignificantimpacts.

A brief reviewof the historyof planningin this areais importantto understand.

Planningin Eastlakestartedin the 1980s. Thesitehaslongbeendesignatedfor Research andLimitedManufacturingusesandzonedfor hospitalusewith approvalof aconditional usepermit. TheEastlakeII SPAPlanwasadoptedon November16, 1999, by Resolution 19666. It wasamendedon December18, 2007, by Resolution2007-299, andAugust23, 2005. Today, the planningandzoningremainsthesame.

Consistentwith CEQA’s alternativeevaluationrequirements, the EIRanalyzeda reducedprojectalternativewith half the numberof beds. Thisalternativewasrejected becauseit did not meet the project objectives, nor did it reduceany impacts. The EIRalsoanalyzeda NoProjectAlternativewhichessentiallyevaluateswhatcouldbebuilt by-rightonthe site. Thatincludesa200,000squarefoot medicalofficebuilding.

It hasbeensuggestedthat the EIRissomehowbiasedbecauseEBHcommissioned it. Thatis simplyfalse. Not onlyis it the commonpracticeof the city of ChulaVistaand mostcitiesin the stateof Californiafor the applicantto commissionthe EIR, but the city alsothoroughlyreviewsthe draftEIRandultimatelyadoptsit asitsown.

Notwithstandingthe factthat thisProjectdid not requirepreparationof anEIR, it neverthelessevaluatedareasonablerangeof alternativesin compliancewith CEQA.

APPEALISSUE #2
FactualError: TheApplicantmaderepresentationsregardingeconomicimpactthat were factuallyin error.

EBHRESPONSE:

As part of EBH’s presentationto the PlanningCommission, we statedthat the Projectwould generatetax revenuein excessof $1 million annually. Thisis a factual statementsupportedby the reportfrom PropertyValuationServicesshowingestimated tax revenueof over $1.2 million. Thus, therewasno factualerror in EBH’s statements abouttheProject’seconomicimpact. Thetaxestimatereportisattachedto thisletteras Exhibit1.

APPEALISSUE #3
NewInformation: ApplicanthadExpartecommunicationwith theCouncilthat wasnot disclosedormadepublic.

EBHRESPONSE:

It is accuratethat membersof the EBHteamcommunicatedandmet with Mayor CasillasSalasand CouncilmemberMcCann. Thosemeetingswere at their requestand shouldbedisclosedby the MayorandCouncilmanat the appealhearing. TheEBHteam did not haveanycommunicationswith PlanningCommissioners, thusnodisclosureswere necessaryat the PlanningCommissionhearing. We alsounderstandthat manyof the opponentscommunicatedwith theMayorand/or Councilmembers, andevenreachedout to PlanningCommissionersbasedon disclosuresmadeby Commissionersat the Planning Commissionhearing. All those disclosuresshouldalsobe madepublic at the appeal hearing, renderingthisissuemoot. Weassumethe CityAttorneywill weighin furtheron thisissueif necessary.

APPEALISSUE #4
FindingsNotSupported: TheApplicantpreparedtheEIRbutfailedto addressandanswer communityquestionsandinput.

EBHRESPONSE:

Onceagain, theapplicantchoseto prepareanEIReventhoughit wasnottechnically required. TheEIRprocessprovidedmaximumopportunityfor publicdisclosureandinput.

Throughoutthereviewprocess, EBHmetwithorofferedto meetwithanyonewhowanted to discusstheprojectandmetwithmanygroupsto dojustthat. Thecityreceivedover400 publiccommentsontheEIRafterit wascirculatedfor publicreview. Eachoneof thepublic commentswererespondedto andthosecommentsandresponsesarepartof thefinalEIR.

Notably, mostof the commentswererelatedto the typesof patientsEBHwill serveand didnotaddressanyenvironmentalissues.

EBHincooperationwiththecityalsohostedacommunityopenhouseinSeptember 2019duringwhichwe had expertspresentto answerquestionsaboutmatterssuchas approvals, security, operations, traffic, andother issues. Over200peopleattendedand submittedwrittencommentswhichEBHrespondedto aspartof thecity’sreviewprocess.

Thoseresponsesareattachedto thisletter asExhibit2. AlsoattachedasExhibit3 isthe OperationalPlanthat EBHofferedandwasmadeaconditionof thePlanningCommission’s approval. EBHalso hosted a website with ongoing Project updates, videos, and opportunitiesfor comment.

Theevidenceclearlyshowsthat EBHmadesignificanteffortsto outreachto the publicandrespondto issues. Asa result, therearenumeroussupportersof the Project.

Thus, thisappealissueiswithout merit.

APPEALISSUE #5
NewInformation: Applicantfailedto provideupdatedor completedisclosures.

EBHRESPONSE:

Thecity requiresanOwnershipDisclosurebefiled with the originalapplicationat the time the Projectis submitted. Wecompliedwith this requirementin 2019. Thecity alsorequirestheOwnershipDisclosurebeupdatedto reflectanychangesduringthereview process. In this case, nothingchangedbetween2019andnow. Thus, no updatewas necessary. Notwithstanding, EBHhassinceprovidedareplacementOwnershipDisclosure with the onlychangesbeingthe dateandthe signatureonthe form. Assuch, thisappeal issuelacksmerit.

CONCLUSION
Theintentof thisletteristo refuteeachof the specificissuesraisedin theappeal of the PlanningCommission’sapproval. WearealsoattachingasExhibit4 a copyof the letter submittedto the PlanningCommissionwhichprovidesmoredetailedbackground andinformationaboutthe Project. Asoutlinedabove, we believethe appealis without meritandthisletterandtheattachmentsprovidesubstantialevidenceto denytheappeal andaffirmthePlanningCommission’sapprovalof thisimportantProject.

Sincerely,
RobinMadaffer, Esq.
cc: GlenGoogins, CityAttorney
MikeShirey, DeputyCityAttorney
TiffanyAllen, DevelopmentServicesDepartment, Director
LauraBlack, DevelopmentServicesDepartment, AssistantDirector D. ToddPhilips, DevelopmentServicesDepartment, PlanningManager StanDonn, DevelopmentServicesDepartment, SeniorPlanner
Exhibit1
Acadia Healthcare Company Inc
JW Scripps JV Chula Vista, CA Facility
Parcels: 595 710 11 00 595 710 12 00
Tax Estimate
PVS has been provided with total JW Scripps JV Chula Vista project costs of 73, 945, 000. The most recent 2021 tax rate for parcels 595 710 11 00 595 710 12 00 is 1.6287%. Applying the most recent tax rate to the total project costs creates estimated PP/ RE taxes of 1, 204, 356. The estimate covers both parcels.

This is a rough estimate due to the limit information known about JW Scripps JV Chula Vista project.

Once more information is known about the cost breakdown, we can narrow down the estimate. It is likely nontaxable items are included in the 73, 945, 000 total project costs.

Thank you,
Blake Cynor
Property Valuation Services
Real Estate Tax Consultant
14400 Metcalf Avenue
Overland Park, KS 66223
913 563 3572
bcynor@propertyvaluationservices. net
Exhibit2Exhibit3
1 EASTLAKE BEHAVIORAL HEALTH HOSPITAL
9/ 26/ 19 Informational Open House
Summary and Responses to Comments
2/ 12/ 20 Update

EVENT SUMMARY
On Thursday, September 26, 2019, Scripps Health and Acadia Healthcare hosted an informational open house for interested members of the public to learn more about their plans to develop a 120- bed inpatient behavioral health hospital on a vacant 10. 5- acre parcel in the commercial district of Eastlake. The event was held in the Multi- Purpose Room at Montevalle Recreation Center from 6: 00- 8: 00 p.m. Approximately 85 people signed in at the check- in station. However, not all attendees elected to sign in. Based on visual estimates, approximately 200 people attended the workshop.

The open house format provided the opportunity for Scripps and Acadia to share far more information about the project than would have been possible in a single presentation. It also allowed for members of the public to speak directly with subject matter experts on a variety of focused topics related to the project. Information was provided at the following information stations:

Project Overview and Project Review Process
Traffic and Transportation
Architecture and Design
Operations and Security
Patient Care
Scripps/ Acadia Partnership
Prevention and Outreach
Copies of the informational displays at each station are attached for reference.

Executives and subject matter experts from Scripps, Acadia and their consultant teams staffed these information stations and were available to interact directly with open house attendees. The following staff were present at the workshop:

Scripps Health
Tom Gammiere, FACHE, Corporate Senior Vice President, Regional Chief Executive - South Jerry Gold, Ph. D., Administrator, Scripps Behavioral Health Debra McQuillen, RN, MAS, Vice President, Chief Operations Executive, Scripps Mercy Hospital Amy Roark, RN, MSN, Manager, Patient Care, Psychiatric Acute Melvin Lumagui, RN, Supervisor, Patient Care, Psychiatric Liaison Team Melody Thomas, Manager, Case Management and Social Services David King, Manager, Security, Scripps Mercy Hospital
2 Pam Gholson, Supervisor, Scripps Behavioral Health Unit Access/ Discharge Monica Montaño, Director, Community Relations
Nallely Valdivia, Executive Assistant ( Spanish translation) Acadia Healthcare
Michael Genovese, M. D., J.D., Chief Medical Officer
Andy Hanner, Chief Strategy Officer
Anne Kelly, BSN, Ed. D., Chief Compliance Officer
Richard Clark, FACHE, President, Western Group
Dwight Lacy, President, Western Division
Debbie Strzlecki, Senior Vice President, Business Development Saad Niazi, CEO, Pacific Grove Hospital ( an Acadia facility) Whitney Chavez, RN, Chief Nursing Officer, Pacific Grove Hospital ( an Acadia facility) Randall Goldberg, Military Support Services
Technical Consultants
John Boarman, PE, Linscott, Law & Greenspan Engineers ( Traffic Consultant) Stephen Wen, AIA, SWA Architects ( Project Architect)
Tina Go, AIA, SWA Architects ( Project Architect)
Chip Hill, AIA, LEED AP, Stengel Hill Architects ( Program Architect) Brad Lenahan, ASLA, Ground Level San Diego ( Landscape Architect) Robin Madaffer, San Diego Land Lawyers ( Land Use Counsel) Farah Mahzari, San Diego Land Lawyers ( Project Manager) Kristen Byrne, Byrne Communications ( Community Outreach) Workshop attendees were given the opportunity to submit written comments on the project. A total of 130 comment cards from 110 individuals were received. Responses to comments received are provided below. Because many duplicate comments were received, the responses are provided to comment topics rather than each individual comment.

COMMENTS AND RESPONSES
Issue Response

1. Residents are concerned that the facility
will be a danger to them because it is
located in close proximity to homes,
schools, family- friendly businesses, etc.

The Eastlake behavioral health hospital is
proposed for a 10. 5- acre site within a
commercial district in Eastlake. The site’s
zoning allows for a hospital use with a
Conditional Use Permit. While there is a
residential neighborhood nearby, it is
separated from the property by both
topography and infrastructure, and there is
no legal direct access between the
property and the adjacent neighborhood.

The closest residences are approximately
3 Issue Response
140 feet away from the building and
approximately 90 feet from the property
line. In addition, the property is at a
significantly higher elevation than the
homes. The proposed project also includes
a perimeter wall and significant
landscaping that will provide an additional
buffer between the facility and the nearby
neighborhood.

It is common for behavioral health facilities
to be located in close proximity to homes,
schools, houses of worship, and
businesses, including Acadia facilities in
other parts of California. In San Diego
County, Aurora Behavioral Health in
Rancho Bernardo, Bayview Behavioral
Health Hospital in Chula Vista, and Sharp
Mesa Vista in Kearny Mesa are located in
commercial areas in close proximity to
residences, schools, parks, etc. Please see
attached exhibits for locations of other
similar facilities.

Because hospital policy will ensure that
discharge plans include secure
transportation for patients to their home or
next care site, loitering and trespassing in
close proximity to the hospital is not
anticipated to be an issue. In addition, a
number of security measures will be
incorporated, including controlled access
to the facility and between units, one public
entry and exit, 24- hour monitoring of
common areas, minimum 15- minute
patient checks, and design features to
encourage safety. Security personnel will
be on site 24- hours a day to monitor the
hospital and the surrounding area.

It' s worth noting that Pacific Grove
Behavioral Health Hospital and San Jose
Behavioral Health Hospital, Acadia facilities
4 Issue Response
in Riverside and San Jose respectively, are
both located in commercial areas in close
proximity to residences, schools, family-
friendly business, childcare centers, houses
of worship and more, and they both enjoy
positive relationships with their neighbors
see attached exhibits highlighting
locations). In fact, the Riverside Planning
Commission recently approved a new
Conditional Use Permit for Pacific Grove to
expand and they removed the requirement
for on- site security because they felt it was
not needed.

2. Residents suggested that the facility be
relocated to a more remote location, away
from residents, schools, etc. Suggestions
included a location south of Main Street or
near the prison in Otay Mesa.

Hospitals are best located in areas where
they are proximate to the populations
served, so locating this facility in a remote,
hard to access area is not in the best
interests of patients. The Eastlake behavioral
health hospital will not be a forensic hospital
treating patients in the criminal justice
system, so locating it near a prison is not
appropriate.

3. Residents suggested that the facility be
relocated to a site in western Chula Vista or
to downtown San Diego, closer to the
population it will serve.

The need for behavioral health services
crosses all socio- economic and geographic
boundaries, and all communities include
residents with behavioral health needs.

Based on national estimates of the incidence
of mental illness in the adult population,
nearly 90, 000 people in South County will
have a mental health need. And there are
not nearly enough beds – countywide or in
South County – to meet current needs.

Based on recommendations from the
California Hospital Association that there be
50 inpatient behavioral health beds for every
100, 000 population, South County should
have 246 inpatient beds, but only 103 beds
are available ( the City of Chula Vista should
have 134 beds, but currently has only 64
beds available). The Eastlake behavioral
health hospital will significantly expand
behavioral health treatment capacity and
will be an important step towards addressing
5 Issue Response
the mental health epidemic and significant
unmet behavioral health treatment needs in
the community.

4. Residents asked how this site was
determined to be the best location and
what other sites were considered.

Scripps and Acadia considered a number of
potential sites throughout the county. The
Eastlake site best met the criteria that the
healthcare organizations were seeking
including:

Location in an area underserved by
inpatient beds ( based on
recommendations from the
California Hospital Association that
there be 50 inpatient behavioral
health beds for every 100, 000
population, the city of Chula Vista
should have 134 inpatient beds, but
only 64 beds are available. Proximity
to major road network)
Appropriate size ( 10+ undeveloped
acres) to construct a one- story
facility
Zoning that allows for a hospital use

5. Residents were concerned that there was
no input from the community in the
selection of the site.

It is not customary, nor is it required by the
City of Chula Vista Public Participation Policy,
for a project applicant to seek public input
before selecting a property for a proposed
project. There are, however, a number of
opportunities to provide public input
throughout the project review process
including the open house, the public review
period for the CEQA environmental review,
and public hearings. All plans and
information submitted to the City of Chula
Vista are publicly available and members of
the public are free at any time to submit
comments to city staff that will be included
in the public record for review and
consideration by decision makers before
they vote on the project. Additionally, a
thorough public review and approval process
was conducted when the plans for the
6 Issue Response
Eastlake Commercial District were approved.

This plan included the zoning that includes a
hospital as an allowable use on the site.

6. Residents felt that locating this facility in
South Bay was discriminatory and that
South Bay gets undesirable facilities
because they have a higher proportion of
lower income and minority communities
than other areas of the county.

The Eastlake behavioral health hospital will
be a new, state- of- the- art facility providing
an important public health service for the
community. Contrary to this being a burden
on the community, it is addressing an urgent
unmet need in the community and will
provide behavioral health treatment to
members of the community that are in need
of care. Just like an acute care hospital,
emergency services, law enforcement, and
utilities, facilities of this type are an
important part of a community’ s
infrastructure. While the number of
available beds in San Diego County is not
nearly enough to meet the existing need,
inpatient behavioral health facilities are
located throughout the county including in
Rancho Bernardo, Escondido, Kearny Mesa,
La Mesa, and Hillcrest.

There have been questions asked about
whether this will be a facility like the County
Mental Health hospital on Rosecrans in San
Diego. Both the Eastlake Hospital and the
County Mental Hospital ( CMH) will be/ are
free standing LPS-designated hospitals
allowing for involuntary detention of
patients. Both hospitals will be or are
accredited by The Joint Commission and
certified by the Center for Medicare and
Medicaid Services ( CMS). Both are or will be
licensed by the California Department of
Public Health as an acute psychiatric
inpatient facility. The Eastlake Hospital will
serve the adolescent, adult, and senior
populations. It will be able to accept all
payors - commercial and government
funded - while CMH focuses on the
underfunded or unfunded population. CMH
also only serves the adult population.
7 Issue Response
While the Eastlake Hospital will have an
intake department and allow for some walk-
in patients, walk- ins will be less significant
than at CMH. Patients admitted to the
Eastlake hospital will primarily be brought in
after medical clearance at other facilities or
after they have been seen and cleared by a
medical professional or, in some cases, by an
EMT. CMH has an Emergency Screening Unit
to triage patients that either walk in or are
brought in by law enforcement. CMH also
operates a Crisis Stabilization Unit ( CSU) that
allows for patients to stay for up to, but not
to exceed, 24 hours. Once stabilized they are
referred to another level of care. The
Eastlake hospital does not plan to have a CSU
attached to their facility. CMH provides
psychiatric clearance for the incarcerated
population that are released from the jail
and tends to receive many forensic patients.

The Eastlake Hospital will not include a
forensic unit.

The Eastlake hospital will also have robust
outpatient mental health offerings such as
intensive outpatient and partial
hospitalization programs while CMH has
limited outpatient offerings and uses
community resources to complete the
continuum of care.

7. Residents expressed concern that there
was no public transit available for patients,
employees, or visitors.

SDMTS Route 707 serves the Eastlake area
and the closest bus stop to the site is at
Boswell Road and Lane Avenue. However,
patients ( both inpatient and outpatient) will
arrive and depart by coordinated, secure
private transportation so access to public
transportation will not affect patient access.

A draft traffic impact analysis is being
conducted to assess the potential traffic
impacts of the project, taking into account
trips generated by patients, employees,
visitors, and others.
8 Issue Response

8. Residents expressed concern that there
was already traffic in Eastlake and that this
project will make it worse.

All intersections and road segments within
the traffic study area, with one exception,
currently operate at acceptable levels of
service ( between LOS A and D). The
exception is the intersection at Harold Place
and Fenton Street, which currently operates
at LOS F during the p. m. peak period. A draft
traffic impact analysis is being conducted to
assess the potential traffic impacts of the
project on all road segments and
intersections within the traffic study area.

It is important to note that other allowed
uses for the property could result in
significantly higher traffic impacts than a
behavioral health hospital. A general
medical/ surgical hospital has a trip
generation rate of 20 trips per bed, while
similar behavioral health hospitals have
shown a trip generation rate of less than five
trips per bed. A manufacturing use ( allowed
by right under the zone) would generate four
trips per 1, 000 square feet and would have
significantly greater peak period impacts
than the proposed use. The attached trip
generation table provides more details
about anticipated trip generation rates.

9. Residents commented that this is not an
appropriate location because it is not near
an acute care hospital or other support
services.

Because patients will be admitted to the
Eastlake hospital to receive inpatient and
intensive outpatient treatment for
behavioral health conditions not requiring
intensive, simultaneous medical treatment
of the type undertaken at integrated
medical/ surgical ( i.e. acute care) facilities, it
is not necessary for it to be located adjacent
to an acute care medical hospital. Like all
licensed hospitals, the Eastlake hospital’ s
clinical staff will have the full ability to safely
provide for the needs of its behavioral health
patients ( including in- house pharmacy and
medication dispensing), who in some cases
may also be living with chronic but stable
medical conditions such as diabetes, heart
9 Issue Response
disease, hypertension and those affecting
mobility. Therefore, the lack of co- location
with or immediate proximity to a
medical/ surgical hospital or related acute
care treatment sites will not negatively
impact the hospital’ s ability to provide high
level, quality care to its patients.

Support services such as daily medical visits
by an internist, nutrition support, and
physical therapy will be provided at the
hospital. Outpatient services will also be
provided for inpatients ready for step down
care.

Social workers will also be employed by the
hospital to facilitate referrals and transfers
to follow- on care facilities and housing for
those that need it.

10. Residents are concerned that emergency
response is already slow in Chula Vista due
to a shortage of police officers and that this
facility will result in increased calls to
police.

Inpatient behavioral health hospitals are
secure, locked facilities with highly trained
staff who are specifically equipped to deal
with the unique needs of behavioral health
patients. Because of this, emergency calls
from these facilities, including those for
police assistance, are uncommon. At Acadia
inpatient hospitals for the period between
January 2016 and December 2018 there
were a total of 1, 079 calls for service that
occurred. During this time there were nearly
456, 000 patient admissions, meaning that
emergency service calls occurred at a rate of
about one- quarter of one percent of all
patient admissions. Given these facts,
potential emergency service calls, whether
to police, fire or EMS, are not expected to
produce any appreciable affect nor “ drain”
on these public resources.

11. Residents asked what happens when
patients are released from the facility.

They are concerned that patients released
from the hospital will wander in their
neighborhood, loiter, increase
In the overwhelmingly majority of cases,
behavioral health inpatients continue to
receive care until the attending psychiatrist
in consultation with the other members of
the clinical team determines that safe
10 Issue Response
homelessness and public drunkenness,
and commit crimes in the neighborhood.

They also wondered what happens if
patients don’t have a ride when they leave
the facility or refuse transportation. They
also asked if patients who haven’ t
completed treatment could check
themselves out and be a danger to the
community.
discharge is clinically indicated based on the
patient’ s treatment progression and
individual circumstances. Prior to discharge,
patients must have a detailed discharge plan
that outlines the specifics of the transition to
and location of their next stage of care ( e.g.
nursing home, residential treatment center,
long term rehabilitation, transitional or
temporary housing, personal residence). It is
Acadia’s policy to include arranged
transportation to the specific post treatment
care location for all patients upon discharge,
either by hospital personnel or in some cases
by the patient’ s family, legal guardians, or
other authorized individuals such as military
base commanding officers or their
designees. The lack of such a post discharge
plan ( including the arranged transportation
component) will likely comprise an
important determining factor on whether
discharge is clinically appropriate. Therefore,
the fear of patients loitering in the
neighborhood is unlikely to be an issue.

It is rare for a voluntary status patient to
request discharge before treatment is
complete. The vast majority of patients
admitted proceed through their clinically
recommended course of treatment,
including full discharge and post care
planning. In the unlikely event that a
voluntary patient was admitted but wished
to be discharged before treatment is
completed, California law allows for patients
that request discharge against medical
advice ( AMA) to be reassessed to determine
if, in the clinical opinion of the psychiatrist,
they pose a danger to themselves or others.

If they are deemed to pose a danger to
themselves or others, they will not be
discharged. If they are deemed not to be a
risk, then they can be discharged per their
11 Issue Response
request and will be provided secure
transportation to their next destination.

With respect to whether patients could be a
danger to the community, contrary to
sensationalized, often outdated and largely
debunked stereotypes and misconceptions,
most patients experiencing behavioral
health conditions are neither dangerous nor
inherently prone to violence, particularly
when receiving professional, compassionate
treatment in structured and therapeutic
inpatient or outpatient settings.

12. Residents are concerned that patient
elopement will be a common occurrence
and that patients who elope will be a
threat to public safety. They wanted to
know if residents will be notified of
elopements and what happens when an
elopement occurs.

Elopement is a commonly used behavioral
health industry term to indicate that a
patient receiving inpatient care has departed
the hospital ( for any length of time) without
the consent or knowledge of the facility’ s
clinical staff and in the absence of a formal
discharge determination and plan.

Elopements can encompass a wide range of
scenarios ranging from largely innocuous
e. g. voluntary patient electing to end
treatment but not signing formal AMA
discharge paperwork, short duration
elopements with immediate return) to more
serious ( e. g. involving minors, involuntary
patients, longer duration incidents). Acadia
adheres to strict protocols and policies to
limit the number and severity of elopements.

These include detailed assessment and
screening for such behaviors at admission,
seen and unseen security features at all
facilities ( physical barriers, video surveillance
of exterior and common areas, boundary
and verbal de- escalation techniques,
minimum of 15 minute patient welfare
checks, secured units for involuntary
patients, etc.), and immediate response in
the uncommon instances when they do
occur.
12 Issue Response
Overall, elopements at Acadia facilities are
exceedingly rare. Over the period from
January 2016 through December 2018, there
were a total of 643 elopements that
occurred at Acadia inpatient hospitals. Over
this same period there were nearly 456, 000
patient admissions, meaning that elopement
occurred at a rate of about 1/ 10 of one
percent of all patient admissions. More than
99% of these incidents were of a short
duration ( less than 24 hours) and did not
involve any injuries to patients or staff,
criminal activity, property damage, nor
disturbances to any surrounding business or
residential communities.

Acadia consistently endeavors to adopt and
refine its policies and procedures to further
reduce the prevalence of elopements. The
Eastlake hospital will utilize the latest design
features, including those intended to
diminish the frequency and severity of
elopements. We also believe it is very
important to place the issue of elopements
in an appropriate and objective context,
including balancing these highly isolated,
rarely detrimental events with the overall
positive public heath value and benefit that
the Eastlake hospital will provide to
thousands of patients in need and their
families.

13. Residents are concerned that their home
values will be reduced because of the
proximity of the facility.

Residential property values are
dynamic and influenced by a large number
of factors, including supply and demand,
economic outlook, location, proximity to
and quality of schools, unemployment
rates, and mortgage interest rates, among
many others. It is therefore very difficult if
not impossible to attribute one specific
factor ( including nearby commercial
property development) to an increase or
decrease in property values.
13 Issue Response
A variety of studies have been conducted
about how various community facilities may
affect property values. Some have identified
small negative correlations, while others
have not identified any statistically valid
negative correlations. For example, a 2019
study published by the National Bureau for
Economic Research conducted by
researchers at the University of New Mexico
and Temple University and covering a period
of 13 years, found no negative property
value changes as a result of substance abuse
treatment facilities located within residential
neighborhoods ( See MarketWatch
article and Barron' s article on the study
findings).

14. The project drawings do not show a 12-
foot fence.

There are two different types of fence
proposed for this project. One is the 12’-0”
security fence around the outdoor activity
yards adjacent to four of the six- patient
wings. The other two patient wings’ outdoor
activity yards are completely enclosed by the
building structure in the center of the facility
hence no fence is required.

The other fence is the campus perimeter
fence on the east, north and south borders
of the property. The city zoning regulation
stipulates that all property perimeter fences
shall be limited to 6’-0” in height. However,
if the city permits, the project is willing to
consider increasing the perimeter fence
height from 6’-0” up to 8’-0”. The 8’-0” fence
around the perimeter of the property is
shown on the site section rendering as well
as the birds eye view color rendering looking
south at the back side of the facility.

15. A resident stated that there was an
inaccuracy on one of the informational
displays that showed that the closest
school was 1, 013 feet from the proposed
site, when there is a school on Showroom
The distance from the proposed hospital site
to the closest school on one of the
informational displays cited an estimated
distance to the closest public school
Eastlake Middle School). The commenter is
correct that there is a private school and
14 Issue Response
Place along with businesses that cater to
children.
businesses that cater to children located on
Showroom Place, approximately 850 feet
from the property line .

16. Is this a temporary facility until the
reconstruction of Scripps Mercy Hospital
San Diego is complete?
The Eastlake behavioral health hospital
would be a permanent facility that would
provide more than three times the number
of inpatient behavioral health beds than
Scripps Mercy San Diego currently has
available.

17. A concern was expressed that technical
studies would be biased because they
were funded by the project applicant.

All technical studies requested by the City to
analyze the potential impacts of a private
project are paid for by the applicant. City of
Chula Vista staff and third party technical
experts review all studies prepared and must
sign off on them before they are accepted by
the city.

18. Some residents expressed support for the
facility due to the unmet need in the
community.

Behavioral health is one of the most
significantly underfunded and under
addressed issues we have nationally and in
the state of California. Nearly 1 in 4 California
adults has a mental health need ( equating to
about 10 million people) yet half of them do
not get the treatment they need. The
California Hospital Association recommends
that 50 inpatient behavioral health beds be
available for every 100, 000 population.

Based on this information South County
should have the City of Chuls Vista should
have 246 beds to meet its behavioral health
care needs but presently only has 103 beds
available. The Eastlake behavioral health
hospital will be an important step towards
addressing these unmet behavioral health
needs in the community.

19. Some residents did not favor the open
house meeting format and were
disappointed that city officials were not
there to hear their comments.

According to the City of Chula Vista Public
Participation Policy, a Community Meeting is
required for projects that result in a
significant response to the Notice of
Application. This meeting is required to be
held early in the process, after the project
application has been deemed complete
and the first internal review of the project
15 Issue Response
has been completed. The meeting is
required to be held early enough in
the process to allow for public comments to
be considered by the applicant and staff
and appropriate changes made to
the project. The policy states that while staff
will help facilitate the Community Meeting,
the Applicant will have the primary
role since this is their opportunity to
dialogue with potential future neighbors.

The policy states that City staff’ s role is to
help set meeting locations
and be available to answer questions about
the process, policies and regulations
affecting the project. The policy further
states that “ An ‘ Open House’ format will
be used at the Community Meeting.”
The purpose of the open house meeting was
to provide detailed information about the
project and seek comments from the public.

It was held early in the process, after the first
set of comments on the project had been
received on the first project submittal. The
open house format allowed Scripps and
Acadia to present far more information
about the various aspects of the project than
would have been possible in a single
presentation. Members of the public had the
opportunity to speak directly with the nearly
30 subject matter experts in attendance
from both Scripps and Acadia to ask
questions and discuss concerns. Participants
were also given the opportunity to submit
their comments in writing, and 130
comment cards from 110 individuals were
received. These comments have been
shared with the City of Chula Vista. Several
staff members from the City of Chula Vista
were in attendance and available to speak
with attendees.

20. Some residents expressed concern about a
recent civil investigation regarding
In May of 2019, Acadia fully resolved a civil
investigation by the West Virginia U.S.
16 Issue Response
Medicare billing fraud in West Virginia that
resulted in a $ 17 million settlement.

Attorney’ s office involving technical and
complex state and federal billing and coding
procedures governing reimbursement for
lab testing services. The settlement, which
did not include any formal findings on the
merits nor admissions of liability by
Acadia, related to alleged practices
originating years prior to Acadia’s acquisition
and operational control of a small number of
medication- assisted treatment clinics
formerly operated by CRC Health
Group. Importantly, there were zero
allegations or issues identified with the level
of quality of care provided to patients or the
medical necessity of such care. To provide
context on settlements of this type, in 2018
aggregate U. S. Department of Justice
healthcare industry legal settlements
including False Claims Act) totaled more
than $ 8 billion, involving hundreds of
medical/ surgical, specialty and behavioral
health hospital operators, including non-
profit, for- profit, academic medical centers,
and government- owned operators.

Acadia and its subsidiaries cooperated fully
with all involved parties during the entire
course of the investigation and was pleased
to have reached this resolution and continue
to dedicate attention and resources towards
serving the needs of patients and their
families.

21. Residents submitted a number of
questions about specific incidents and
allegations involving Acadia facilities.

The individual incidents cited on comment
cards appear to fall into three categories: 1)
allegations of abuse/ negative patient
incidents, 2) elopement, and 3) allegations of
corporate/ civil fraud and litigation. Rather
than responding to each individual incident
which may implicate privacy, litigation
and/ or subject to factual debate as they are
likely pulled from media reports, our
responses below focus on the performance
of Acadia and its facilities in the aggregate,
17 Issue Response
rather than individual incidents. The
information below provides important
context to the overall quality of care Acadia
provides to millions of patients each year.

ALLEGATIONS OF ABUSE/ NEGATIVE PATIENT

INCIDENTS
No large health or hospital system providing
treatment to millions of patients across
hundreds of facilities, whether behavioral
health or medical- surgical, will ever be
completely immune from isolated incidents
or sporadic undesirable patient experiences.

By its nature, the healthcare industry carries
inherent risk as its “ customers” – the
patients – seek services because they are
sick. Notwithstanding the large numbers of
patients treated across hundreds of care
sites, the rate of grave and serious incidents
at Acadia’ s inpatient hospitals is small. Over
the period from January 2016 through
December 2018, there were a total of 2, 496
incidents that occurred over nearly 456, 000
patient admissions, a rate of about one half
of one percent of all patient admissions.

Serious incidents include major injuries or
impairments, patient death, and allegations
or occurrences of abuse, negligence, error,
or omission that affects rendering of
professional services). While the comments
submitted highlight individual incidents in an
effort to question Acadia’s quality of care,
the fact is that nearly 99. 5% of Acadia’s
inpatient admissions do not result in
negative incidents and Acadia provides
desperately needed care to patients
suffering from behavioral health illnesses.

In the rare instance where an outcome or
event at an Acadia treatment facility
deviates from our high standards and
expectations, we fully investigate the
situation to determine lessons learned and
18 Issue Response
whether updates to procedures and policies
are warranted, including holding employees
fully accountable for any improper actions
that depart from employee training and
Acadia’s values. Acadia’s overall focus during
these uncommon situations is to provide
support to anyone negatively impacted and
to work expeditiously to diminish the
possibility of similar matters re- occurring.

Ensuring that we can maintain a consistently
safe, therapeutic and compassionate care
environment for all patients is and will
always remain a top priority of Acadia.

Acadia facilities strictly adhere to all
reporting requirements and maintain strong
track records on multiple independently
administered, evidence- based clinical quality
performance tracking and measurement
programs. These include The Joint
Commission’ s HBIPS ( Hospital Based
Inpatient Psychiatric Services) Core
Measures and CMS’ Inpatient Psychiatric
Facility Quality Reporting Program ( IPFQR)
used by over 1, 600 psychiatric hospitals to
measure clinical accountability metrics
linked to improved patient outcomes. In
aggregate, Acadia’ s behavioral health
facilities meet and often surpass the national
and state average in the majority of
measured categories, including those
related to patient safety. Acadia consistently
endeavors to improve its aggregate scores as
part of its overall quality assurance initiatives
and clinician training programs.

ELOPEMENT
Elopement is a commonly used behavioral
health industry term to indicate that a
patient receiving inpatient care has departed
the hospital ( for any length of time) without
the consent or knowledge of the facility’ s
clinical staff and in the absence of a formal
19 Issue Response
discharge determination and plan.

Elopements can encompass a wide range of
scenarios ranging from largely innocuous
e.g. voluntary patient electing to end
treatment but not signing formal discharge
paperwork, short duration elopements with
immediate return) to more serious ( e.g.
involving minors, involuntary patients,
longer duration incidents).

While the incidents cited in comments make
it seem as though elopement is a frequent
occurrence, elopements at Aadia’s inpatient
hospitals are rare. Over the period from
January 2016 through December 2018, there
were a total of 643 elopements that
occurred at Acadia inpatient hospitals. Over
this same period there were nearly 456, 000
patient admissions, meaning that elopement
occurred at a rate of about 1/ 10 of one
percent of all patient admissions. More than
99% of these incidents were of a short
duration ( less than 24 hours) and did not
involve any injuries to patients or staff,
criminal activity, property damage, nor
disturbances to any surrounding business or
residential communities..

Acadia adheres to strict protocols and
policies to limit the number and severity of
elopements. These include detailed
assessment and screening for such behaviors
at admission, seen and unseen security
features at all facilities ( physical barriers,
video surveillance of exterior and common
areas, boundary and verbal de- escalation
techniques, minimum of 15 minute patient
welfare checks, secured units for involuntary
patients, etc.), and immediate response in
the uncommon instances when they do
occur.
20 Issue Response
Acadia consistently endeavors to adopt and
refine its policies and procedures to further
reduce the prevalence of elopements. The
Eastlake hospital will utilize the latest design
features, including those intended to
diminish the frequency and severity of
elopements. We also believe it is very
important to place the issue of elopements
in an appropriate and objective context,
including balancing these highly isolated,
rarely detrimental events with the overall
positive public heath value and benefit that
the Eastlake hospital will provide to
thousands of patients in need and their
families.

ALLEGATIONS OF CORPORATE/ CIVIL FRAUD

AND LITIGATION
Acadia Healthcare disputes any allegation or
contention that it or its subsidiary hospitals
have knowingly engaged in civil fraud.

Nevertheless, in light of the large amount of
federal and state reimbursements providers
receive from government payor programs
coupled with the increasing complexity of
billing and coding protocols, government-
initiated inquiries, information requests,
audits and recoupment actions,
investigations are common occurrences
across the industry and in no way unique to
Acadia. In 2018, aggregate U.S. Department
of Justice healthcare industry legal
settlements ( including False Claims Act)
totaled over $ 8 billion, involving hundreds of
medical/ surgical, specialty, nursing home
and behavioral health hospital operators
including non- profit, for- profit academic
medical centers and government owned
operators. None involved Acadia or any of its
subsidiary facilities.

Acadia cooperates fully with all government
inquiries, even when we strongly disagree
21 Issue Response
and dispute the factual basis and legal merits
of the allegations being investigated. Upon
learning of any allegation of fraud, we work
transparently and collaboratively with all
interested parties, including providing
verifiable evidence, internal clinical
documentation, medical records and
supporting data that refutes and disproves
potential claims of fraudulent conduct. We
continuously work with our clinicians to
improve our documentation evidencing the
critically important care that we provide to
our patients. It is also important to note that
none of the currently disclosed, pending
inquiries have resulted in any formal
demands for payment, government- initiated
lawsuits, or charges of any kind against
Acadia Healthcare or any of its subsidiary
facilities. Contrary to nearly all of our
similarly- sized hospital provider peers,
Acadia’ s historical False Claim Act- related
lawsuit settlements are extremely small,
comprising a single resolution in our entire
14- year history.

While we are unable to offer detailed
comment on any specific pending litigation,
we hope some important context and
clarifications are helpful. Lawsuits against
Acadia inpatient behavioral health facilities
by patients, their families, former staff and
others are very rare but, as with all large
hospital systems and operators, they do
invariably occur. Nevertheless, Acadia’s
aggregate litigation claims rate is far lower
than the national average, equating to less
that one tenth of one percent of all
admissions between 2016 and 2019 YTD.

Importantly, many of these matters were
ultimately dismissed due to lack of merit
and/ or were resolved for de minimis,
nuisance values far less than the likely cost of
defense.
22 Issue Response
The mere filing of, and even settlement of, a
lawsuit typically does not constitute any
formal findings of fact or admissions of
liability or even reflect the overall merit of a
case. Nearly all companies ( including
Acadia) routinely choose to settle defensible
cases due to the high cost of litigation,
unpredictability of juries and a desire to
remain focused on their core mission.

Similarly, like many large publicly traded
companies, Acadia, its board and executives
may occasionally be named in securities
lawsuits filed by opportunistic trial attorneys
alleging potential improper conduct. These
filings often occur surrounding any
significant downward movement in a
company’ s stock price ( which can and often
does occur for a multitude of uncontrollable
and innocuous factors not involving any
wrongdoing) and may be accompanied by
settlement demands even prior to the filing
of a formal lawsuit and discovery. Acadia
strongly disputes any contention that it, its
subsidiaries or any of its directors or officers
have engaged in any civil or criminal fraud
including related to securities matters) and
we will continue to vigorously defend the
company from any such claims.

It is important to reiterate that the mere
filing of lawsuits and unsubstantiated,
uncorroborated and often false allegations
absolutely do not and should not be
conflated with actual, substantiated
improper or illegal actions on the part of
Acadia.

Exhibit3

EASTLAKE BEHAVIORAL HEALTH HOSPITAL
Operational Profile
11/ 09/ 21
Overview
Scripps Health has entered into a joint venture with Acadia Healthcare to significantly expand its ability to provide quality behavioral health services to patients. The two health care organizations are proposing to develop and jointly operate a new, state- of- the- art 120- bed inpatient behavioral health hospital in the Eastlake community of Chula Vista, CA. Consistent with behavioral health best practices, the hospital will be constructed as a one- story facility to promote patient safety, a therapeutic, nurturing and structured treatment environment and operational efficiency. The hospital will provide safe, quality care and critically needed inpatient bed capacity and intensive outpatient services.

Hours of Operation
The hospital will operate 24 hours per day with three employee shifts. The shifts are anticipated to be 7:00 am– 3:00 pm, 3: 00 pm- 11: 00 pm, and 11: 00 pm- 7: 00 am.

Employees
A total of 150 employees are anticipated to be on site, led by a Chief Executive Officer, Chief Medical Officer, and Chief Nursing Officer. Employees will include physicians, nurses, mental health technicians, intake directors, administrators, maintenance staff, and more.

Ratio of Patients to Employees
All Acadia facilities meet or exceed all state laws and statutes related to patient care, including the ratio of patients to clinical care staff. Other Acadia behavioral health hospitals in the state staff at a minimum 1: 6 ratio of clinical staff to patients ( please note that the ratio is clinical staff to patients, not all staff).

This number can vary, and staff can be added based on the acuity of the patient’ s condition, but it will never be lower than one clinical staff member per six patients.

Number of Patients
There will be a maximum of 120 inpatients. The number of outpatients is projected to range from 20 to 50 patients per day.

Types of Patients
The proposed Eastlake Behavioral Health Hospital will be an inpatient treatment facility providing care for a variety of patients in our area. It will serve adolescent, adult, and geriatric populations and will include specialized programs for distinct patient segments, such as members of the military and veterans. Patients coming to the facility may be referred by their medical providers, emergency departments, community partners ( e.g., schools, senior homes, churches, military installations, public and government service providers), or self/ family referral. Intensive outpatient treatment services will also be offered at the hospital.

Current plans include six separate units with 20 beds each. Consistent with behavioral health best practices, patient populations are housed by age group ( geriatric, adolescent, adult) and acuity but with individualized treatment based on the patient’ s condition and current functioning.

Length of Stay
The average stay for patients admitted to the hospital will be 7- 10 days.

Visiting Hours
Visiting hours are typically from 6 pm to 7 pm to accommodate work schedules of visitors. On some occasions, the clinical staff may meet with the patient and their family to describe the treatment, medication, and discharge plan. This also gives the opportunity for family members to ask questions of the doctor and clinical staff. Visiting hours are distinct from other family interactions that may occur as part of specific inpatient and outpatient treatment programs.

Patient Drop Off and Transportation Plan
Transportation to the hospital will vary depending on the type of referral. If a patient is referred by a primary care physician, community, public health or safety partner, or is a self/ family referral they would likely arrive by private automobile. If a patient is referred from an acute hospital emergency department, they would arrive by ambulance or other professional medical transport service. Sirens would typically not be needed since the transport to the facility would not be deemed an acute medical emergency.

All decisions to admit or discharge a patient will be made by the attending psychiatrist and other members of the clinical treatment team based on the patient’ s current condition and treatment progress. Upon discharge, all patients must have a detailed safe discharge plan guiding their ongoing care and overall well- being including continuity of care ( ongoing medication and treatment) and housing. This plan will include pre- arranged private transportation from the hospital to the patient’ s next destination.

Are patients held involuntarily?
Each state proscribes specific legal protocols for involuntarily committing an individual into inpatient care if he or she is determined ( based on the opinion of one or more designated clinical or public safety experts) to constitute a legitimate risk to themselves or others. It is the current expectation that Eastlake will provide specialized, compassionate behavioral health service to both voluntary and involuntary status patients in full accordance with all legal, ethical, and regulatory requirements.

Are any patients allowed to leave on their own?
In the overwhelmingly majority of cases, behavioral health inpatients ( whether involuntary or voluntary) continue to receive care until the attending psychiatrist in consultation with the other members of the clinical team determines that safe discharge is clinically indicated based on the patient’ s treatment progression and individual circumstances. Prior to discharge, patients must have a detailed discharge plan that outlines the specifics of the transition to and location of their next stage of care ( e.g. nursing home, residential treatment center, long term rehabilitation, transitional or temporary housing, personal residence). It is Acadia’ s policy to include arranged transportation to the specific post treatment care location for all patients upon discharge, either by hospital personnel or in some cases by the patient’ s family, legal guardians, or other authorized individuals such as military base commanding officers or their designees. The lack of such a post discharge plan ( including the arranged transportation component) in many cases comprises an important determining factor on whether discharge is clinically appropriate.

Security Plan
Protecting the safety and security of patients, staff, and the surrounding community is of paramount importance to Scripps and Acadia and a responsibility we take very seriously. The hospital’ s design and operations will integrate countless seen and unseen patient safety and security measures. These include but will not be limited to:

Fencing and landscaping barriers
24- hour security patrols
Controlled access in and out of the facility
Single entrance/ exit on Showroom Place
Closed circuit security camera monitoring of the exterior and common areas ( e.g. lobby, cafeteria, visiting area, outside areas)
15- minute patient safety checks ( maximum, as some patients may require more frequent checks)
Contrary to sensationalized, often outdated and largely debunked stereotypes and misconceptions, most patients experiencing serious behavioral health conditions are neither dangerous nor inherently prone to violence, particularly when receiving professional, compassionate treatment in structured and therapeutic inpatient or outpatient settings. We can provide links to a number of studies and reports that address this issue, upon request.

Oversight and Accountability
The Scripps/ Acadia behavioral health hospital will be fully licensed by the state of California and accredited by The Joint Commission, an independent non- profit organization with a 60- year track record conducting robust inspections, accreditation and quality care clinical assessment surveys on behalf of the federal government. It will also be fully certified and in good standing with all major government e.g. Medicare/ Medi- Cal, Tricare) and commercial payers prior to and at all times after its opening. In the entire 12- year history of Acadia Healthcare and the more than 100 year history of Scripps Health, none of its inpatient or outpatient facilities have ever failed to be accredited, re- accredited, lost its state hospital license or been de- certified by the Centers for Medicare & Medicaid Services ( CMS) or any other government program.

Acadia facilities strictly adhere to all reporting requirements and maintain strong track records on multiple independently administered, evidence- based clinical quality performance tracking and measurement programs. These include The Joint Commission’ s HBIPS ( Hospital Based Inpatient 4 Psychiatric Services) Core Measures and CMS’ Inpatient Psychiatric Facility Quality Reporting Program IPFQR) used by over 1, 600 psychiatric hospitals to measure clinical accountability metrics linked to improved patient outcomes and are published on CMS Hospital Compare website. In aggregate, Acadia’ s behavioral health facilities meet or surpass ( in some cases by large margins) the national and state average in multiple categories, including those related to patient safety. Acadia consistently endeavors to improve its aggregate scores as part of its overall quality assurance initiatives and clinician training programs.

Exhibit4
November 4, 2021
Chair Max Zaker and Members of the Chula Vista Planning Commission c/ o Patricia Salvacion, Secretary – VIA EMAIL - psalvacion@chulavistaca. gov 276 Fourth Avenue
Chula Vista, CA 91910
Chair Zaker and Members of the Planning Commission,
Our firm represents Eastlake Behavioral Health, LLC, (“ EBH”), a joint venture between Acadia San Diego JV Holdings, LLC (“ Acadia”) and Scripps Behavioral Health Venture, LLC (“ Scripps”). EBH is the applicant for a conditional use permit to develop a behavioral health hospital on Showroom Place in Eastlake, Chula Vista (“ Eastlake Hospital” or “ Project”).

It is without question that behavioral health issues are rampant and often lead to catastrophic consequences for families. The pandemic has significantly exacerbated the dire effects on communities. As described in the City’s staff report, both Federal and State laws are in place to encourage and protect facilities that provide services to patients experiencing behavioral health disabilities. Here is a paraphrased excerpt from the City’s staff report:

Pursuant to the Americans with Disabilities Act, disability discrimination is prohibited in all activities of local government entities, including zoning decisions.

This nondiscrimination mandate requires the City to provide equal services, programs, and activities to entities that serve individuals with disabilities and to ensure that the City’s zoning decisions do not discriminate against individuals with disabilities and entities associated with them. The City is further prohibited from utilizing criteria that have the effect of discriminating against individuals with disabilities or applying eligibility criteria that screen out or tend to screen out individuals with disabilities.

Additionally, both Title II of the ADA and the Fair Housing Amendments Act of 1988 42 U. S.C. § 3601) protect the rights of both providers and clients of residential treatment programs and prohibits the exclusion or otherwise denial of equal services, programs, or activities to an individual or entity because of the known actual or perceived) disability of an individual with whom the individual or entity has a known relationship or association. See 28 C.F.R. 35. 108( f)( 1).

Thus, the law prohibits the City from applying its zoning to discriminate against individuals with behavioral health disabilities and entities associated with the m.

This project will be before the Planning Commission for decision on November 10, 2021. We urge you to follow the recommendation of City staff and approve this important project for all the reasons stated in this letter.

THE PROJECT
The Eastlake Hospital is a proposed one- story hospital with 120 inpatient beds that will help address the significant unmet need and increasing demand for high quality behavioral health treatment for patients in our community. It will be a new, modern behavioral health hospital utilizing the latest design elements and state- of- the- art safety and security features to maximize patient comfort and clinical outcomes. Acadia and Scripps will be working to help ensure that the new facility meets and exceeds patie nts’ behavioral health needs and is a good neighbor and asset to the community.

Hospitals are allowed at this site with the approval of a conditional use permit which is what is before the Planning Commission. It meets all the land use planning requireme nts and development regulations outlined in the City’s Municipal Code. The Project is also supported by a full EIR, despite no significant unmitigated impacts.

To enhance your understanding of the project, we had hoped to host the public and Planning Commissioners on a tour of a similar behavioral health hospital owned by Acadia in Riverside, Pacific Grove Hospital. Unfortunately, this was impossible given restrictions in place due to the COVID- 19 pandemic. Instead, we produced a “ virtual tour” video for review. This video showcases both Pacific Grove Hospital and San Jose Behavioral Health Hospital, another facility owned by Acadia. You can access the tour video here:
https:// youtu. be/ sjRUULWqOZg.

As you may know, there have been several questions raised about the project by neighbors about the location of the Eastlake Hospital in the adjacent commercial district.

While we understand the community’ s concern, the fact is that inpatient behavioral health hospitals like the Eastlake Hospital peacefully coexist with residents all over the country.

Acadia has a commitment to providing high quality, compassionate care for its patients.

The goal is to have zero negative patient outcomes. However, by its nature, the healthcare industry carries inherent risk as its “ customers” – the patients – seek services because they are sick. No large hospital system, whether behavioral health or medical- surgical, will ever be completely immune from isolated incidents or undesirable p atient experiences. But the rate of serious incidents at Acadia’ s inpatient hospitals is very small.

From 2016 through 2020, there were nearly 581, 000 patient admissions, and the rate of serious incidents over that time was about 0. 8%. This means that more than 99% of patient outcomes go according to plan and we have helped hundreds of thousands of patients get the care they need to help them recover.

Below are answers to some of the concerns that have been raised during the project review process.

RESPONSES TO QUESTIONS RAISED BY THE PUBLIC

1. Why is it appropriate to locate a facility like this near a residential neighborhood? Healthcare facilities, like hospitals, need to be located within communities near the people they will serve to ensure that patients and their families have convenient access. For this reason, hospitals, including behavioral health hospitals, are most often located near homes, schools, houses of worship, and businesses. In San Diego County, Aurora Behavioral Health in Rancho Bernardo, Bayview Behavioral Health Hospital in Chula Vista, and Sharp Mesa Vista in Kearny Mesa are located in commercial areas in close proximity to re sidences.

Acadia’ s two hospitals in California, Pacific Grove in Riverside and San Jose Behavioral Health in San Jose, are in close proximity to homes, childcare facilities, churches, and more.

Both hospitals enjoy positive relationships with their neighbors. In fact, the Riverside Planning Commission recently approved a new Conditional Use Permit for Pacific Grove to expand the hospital and they removed the requirement for on -site security because they felt it was not needed.

The Eastlake Hospital is proposed for a 10. 5- acre site within a commercial district in Eastlake. The site’s zoning allows for a hospital use with a Conditional Use Permit. While there is a residential neighborhood nearby, it is separated from the property by both topography and infrastructure, and there is no legal direct access between the property and the adjacent neighborhood. The proposed project also includes a perimeter wall and significant landscaping that will provide an additional buffer between the facility and the nearby neighborhood.

2. What are the procedures implemented when patients are discharged? Patients will receive care until the attending psychiatrist, in consultation with the other members of the clinical team, determines that safe discharge is clinically indicated based on the patient’ s treatment progression and individual circumstances. Prior to discharge, all patients must have a detailed discharge plan that outlines the specifics of the transition to and location of their next stage of care ( e. g. nursing ho me, residential treatment center, long term rehabilitation, transitional or temporary housing, personal residence).

The Eastlake Hospital will follow Acadia’ s policy that all patients be provided with arranged transportation to the specific post treatment care location upon discharge. The lack of such a post discharge plan - including the arranged transportation component - will likely comprise an important determining factor on whether discharge is clinically appropriate.

While a patient that is deemed medically fit for discharge cannot be forced to accept transportation, the experience at Acadia’ s two inpatient behavioral health hospitals in California ( that are similar to the proposed Eastlake hospital) demonstrate that this rarely, if ever happens. Records at Pacific Grove Hospital in Riverside and San Jose Behavioral Health Hospital in San Jose indicate that two patients have refused transportation to their next destination after discharge over the last three years.

3. Will the patients in the Eastlake hospital pose a safety risk to the surrounding community?
No. Contrary to sensationalized stereotypes and miscon ceptions, the vast majority of people with mental health problems are no more likely to be violent than anyone else.

Most people with mental illness are not violent and only 3%– 5% of violent acts can be attributed to individuals living with a serious menta l illness. In fact, people with severe mental illnesses are ten times more likely to be victims of violent crime than the general population. It is more than likely that we all know someone with a mental health problem and do not even realize it, because many people with mental health problems are highly active and productive members of our communities.

4. What security measures will be in place at the Eastlake hospital? Protecting the safety and security of patients, staff, and the surrounding communit y is of paramount importance to Scripps and Acadia and a responsibility we take very seriously.

The hospital’ s design and operations will integrate many patient safety and security measures. These include, but will not be limited to, fencing and landscapin g barriers, 24- hour security patrols, closed circuit security camera monitoring including exterior and common areas ( e.g. lobby, cafeteria, visiting area), 15- minute patient safety checks minimum, as some patients may require more frequent checks), and keycard- controlled access to and from the facility and between units.

5. What happens if a patient escapes or leaves without authorization? Elopement is a common behavioral health industry term to indicate that a patient receiving inpatient care has departed the hospital without the consent or knowledge of the facility’ s clinical staff and in the absence of a formal discharge determination and plan. Elopements from secure, inpatient behavioral health hospitals are rare occurrences. At Acadia’ s inpatient behavioral health hospitals over a five- year period from 2016- 2020, a total of 1,128 elopements occurred over nearly 581, 000 patient admissions, a rate of less than 0. 2% of all patient admissions. More than 99% of these elopements were of a short duration less than 24 hours) and did not involve any injuries to patients or staff, criminal activity, property damage, nor disturbances to any surrounding business or residential communities.

Acadia adheres to strict protocols and policies to limit the number and severity of elopements. These include detailed assessment and screening for such behaviors at admission, significant security features at all facilities and immediate response in the uncommon instances when they do occur ( police, family/ next of kin, and attending physician are immediately notified).

Acadia consistently endeavors to adopt and refine its policies and procedures to further reduce the prevalence of elopements. The Eastlake hospital will utilize the latest design features, including those intended to diminish the frequency and severity of elopements.

We also believe it is important to place the issue of elopements in an appropriate and objective context, including balancing these isolated, rarely detrimental events with the overall positive public heath value and benefit that the Eastlake hospital will provide to thousands of patients in need and their families.

6. Do behavioral health hospitals result in more calls for emergency service ( police, fire, etc.)?
Emergency calls ( including for police assistance) from inpatient behavioral health hospitals, including those in the Acadia Healthcare network, are uncommon. Over a five - year period from 2016- 2020 at Acadia’ s inpatient hospitals there were a total of 2, 084 calls for service that occurred over nearly 581, 000 patient admissions, a rate of about 0. 35% of all patient admissions. This is in large part due to the training and expertise of the hospitals’ clinical staff who specifically equipped to deal with the unique needs of behavioral health patients including advanced de- escalation and in rare cases, safe restraint techniques). Given these facts, potential emergency service calls whether to police, fire, or EMS are not expected to produce any appreciable effect on these public resources.

In fact, behavioral health hospitals are seen as a resource by many law enforcement professionals. Many of these facilities are authorized to be police drop- off locations, which allows police to drop off people that are potentially in need of psychiatric care that have not been involved in a crime and are not in need of medical care. With our region’ s current shortage of inpatient behavioral health beds, police must take potential patients to the nearest Emergency Department – whether they need medical care or not – and wait until that patient can be seen by a physician, a process that takes officers out of service for an average of four to six hours. By contrast, when law enforcement has the ability to take a patient directly to an authorized behavioral health hospital that has an available bed, they are typically out of service for 30 to 60 minutes because the patients can be assessed much more quickly.

7. Does a standalone inpatient behavioral health hospital need to be located near a medical acute care hospital and other services?
No. Patients will be admitted to the hospital to receive treatment for behavioral health conditions not requiring intensive, simultaneous medical treatment of the type undertaken at a medical/ surgical facility. Like all licensed hospitals, the Eastlake Hospital’ s clinical staff will have the full ability to safely provide for the needs of its behavioral health patients who in some cases may also be living with chronic but stable medical conditions such as diabetes, heart disease, hypertension and those affecting mobility. Therefore, the lack of co- location with or immediate proximity to a medical/ surgical hospital or related acute care treatment sites will not negatively impact the hospital’ s ability to provide high level, quality care to its patients.

Support services such as having an internist on site daily, nutrition support, and physical therapy will be provided at the hospital. Outpatient services will also be provided for inpatients ready for step down care, and social workers will be employed by the hospital to facilitate referrals and transfers to follow - on care facilities and housing for those that need it.

WE URGE YOU TO APPROVE THIS IMPORTANT LIFESAVING FACILITY IN EASTLAKE We hope that the virtual tour video and answers to concerns about the location of the Eastlake Hospital are helpful. We look forward to presenting this important project before you on November 10, 2021.

For all these reasons we urge you to follow City staff’ s recommendation, federal and state law and approve this important lifesaving facility, the Eastlake Behavioral Health Hospital.

Sincerely,
Robin Madaffer, Esq.
cc: Michael De La Rosa, Vice Chair, Chula Vista Planning Commission Jerome Torres, Chula Vista Planning Commissioner
Gabe Gutierrez, Chula Vista Planning Commissioner
Krista Burroughs, Chula Vista Planning Commissioner
Jon Milburn, Chula Vista Planning Commissioner
Mike Shirey, Deputy City Attorney
Tiffany Allen, Development Services Department, Director Laura Black, Development Services Department, Assistant Director D. Todd Philips, Development Services Department, Planning Manager Stan Donn, Development Services Department, Senior Planner From: Perla Arroyo <[email protected]>
Sent: Monday, January24, 2022 8:02 AM
To: Mary Salas <[email protected]>
Cc: GlenGoogins <[email protected]>; JohnMcCann <[email protected]>; Jill Galvez <[email protected]>; SteveC. Padilla <[email protected]>; Andrea Cardenas <[email protected]>; Michael Shirey <[email protected]>; Tiffany Allen <[email protected]>; StanDonn <[email protected]>; Laura Black [email protected]>
Subject: PLEASESUPPORTTHEEASTLAKEBEHAVIORALHEALTHHOSPITALPROJECT Warning: External Email
Dear Mayor Salasand Members of the City Council:

Asa mental health clinician, I strongly support the EastlakeBehavioral Health Hospital project, proposed by ScrippsHealth and AcadiaHealthcare. It is important that the city maintains up to date with treatment needs. There are multiple issuesthat our community is dealing with and it has a lot to do with the fears and uncertainty around COVID19 aswell asthe significant increase in use and overdoseof fentanyl. Our children, our friends, our neighbors and evensometimesourselves are dealing with someform in mental health need.

This project will significantly expand critically needed behavioral health treatment capacity in the SouthCounty region.

The Eastlake Behavioral Health Hospital project, proposed by Scripps Health and Acadia Healthcare will provide care to our families, friends, neighbors, and coworkers.

The ChulaVista Planning Commissionmade the right decision in approving this project, and I urge you to reject the appeal that project opponents have filed.

Thank you for your consideration.

Sincerely,
Perla Arroyo- Morales LMFT
1037 GuatayAve
ChulaVista CA91911
7605049510
From: bill stellin < billstellin@yahoo. com>
Sent: Monday, January 24, 2022 7: 35 AM
To: John McCann < jmccann@chulavistaca. gov>; Jill Galvez < jmgalvez@chulavistaca. gov>; Mary Salas MSalas@chulavistaca. gov>; Steve C. Padilla < spadilla@chulavistaca. gov>; Andrea Cardenas acardenas@chulavistaca. gov>
Subject: Brad Davis Appeal
Dear Council Members,
I am officially requesting that each and every note of concern listed on the appeal from Brad Davis ( attached for your convenience) be thoroughly and completely addressed at this Tuesday' s meeting.

Failure to thoroughly address ALL concerns will be viewed as a breach of your fiduciary duties as an elected official.

Sincerely,
Bill Stellin
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From: Teri Peters < iamhipechik@gmail. com>
Sent: Saturday, January 22, 2022 5: 48 PM
To: Mayor < mayor@chulavistaca. gov>; John McCann < jmccann@chulavistaca. gov>; Glen Googins GGoogins@chulavistaca. gov>
Subject: Tuesday meeting mental health facility
Dear members
This meeting should be delayed in the name of public health and safety. I have been participating in the debate for three years but cannot attend this meeting due to Omicron. Further, it is adverse to public health and safety to continue with this meeting when our hospitals are on disaster mode. https:// www. sandiegouniontribune. com/ news/ health/ story/ 2022- 01- 18/ south- bay- hospitals- declare- internal- disasters- as-patient- crush- continues
Thank you
T Petros
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From: bibi luko < bibiluko@gmail. com>
Sent: Sunday, January 23, 2022 6: 19 PM
To: Glen Googins < GGoogins@chulavistaca. gov>; Maria Kachadoorian mkachadoorian@chulavistaca. gov>
Cc: Jill Galvez < jmgalvez@chulavistaca. gov>; Mary Salas < MSalas@chulavistaca. gov>; Natalie Flores NFlores@chulavistaca. gov>; johnmccanncouncilmember@gmail. com Subject: Moving Psych Hospital Meeting
Hello,
I’m writing to respectfully request that the meeting for the proposed psychiatric hospital be suspended or rescheduled to a later date. Chula Vista is surging right now and MANY members of our community are sick, or high risk and will not be able to attend.

We are literally at the peak of the omicron surge this week. Please consider the health and safety of our various community members especially since online comments were not read at the previous planning commission meeting.
https:// www. newskudo. com/ california/ san- diego/ government/ 7399075- san- diego- hospital- leaders- predict- end- of- omicron- surge- is- near
Thanks,
Bibi
Bibi Luko
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From: TessaWalkup <[email protected]>
Sent: Sunday, January23, 2022 6:58 PM
To: GlenGoogins <[email protected]>; Maria Kachadoorian [email protected]>
Subject: Request
Warning: External Email
Hello,
I’m writing to respectfully request that the meeting for the proposed psychiatric hospital be suspendedor rescheduledto a later date. ChulaVista is surging right now and MANYmembers of our community are sick, or high risk and will not be able to attend.

We are literally at the peak of the omicron surgethis week. Pleaseconsider the health and safety of our various community members especiallysinceonline comments were not read at the previous planning commission meeting.

Respectfully,
T. Walkup
From: bill stellin < billstellin@yahoo. com>
Sent: Sunday, January 23, 2022 6: 14 PM
To: Maria Kachadoorian < mkachadoorian@chulavistaca. gov> Subject: Covid Concerns
Good evening,
I would like to request a postponement for discussing the Psychiatric Hospital this Tuesday. I have covid and am unable to attend the meeting. As a concerned neighbor within close proximity, I would like my voice to be publicly heard.

I am also extremely concerned about the high number of Covid cases in our area, and do not feel holding an open forum for such a heavily debated topic is a safe decision at this time. You will have a higher than average turnout, and being indoors with such a large population during the peak of Covid poses as too much of a risk. I implore you to postpone this topic to a later date for the safety of all parties involved.

Sincerely,
Bill Stellin
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From: Molly Crawford <[email protected]>
Sent: Monday, January24, 2022 3:08 PM
To: JohnMcCann <[email protected]>; Jill Galvez <[email protected]>; Mary Salas <[email protected]>; SteveC. Padilla <[email protected]>; Andrea Cardenas [email protected]>
Subject: ProposedAcadiaHealth Center
Warning: External Email
Goodafternoon,
Asa citizen and community member of ChulaVista and a parent with children who attend many classes, parties and patronize many businessesthe EastlakeDesignDistrict I am troubled by the lack of information that seemsto be available in regards to the proposed Acadia health site. Not only doesit seemto be a highly inappropriate areafor a mental health facility, but it doesnot seem that the city hasdone their due diligence on the proposal. I ask that you pleaseanswer the questions asstated in the appeal from Brad Davis. Even better would be to postpone tomorrows meeting until we get through the latest pandemic surge to allow voice of the community to be heard. Many of us are in quarantine at home due to possible exposuresor sickness.

Pleaselisten to the voices in your community that you are representing. This is not a decision that should be made with most researching eachand every outcome and possibility.

Thank you for your time,
Molly Crawford
Sentfrom my iPhone
From: bibi luko < bibiluko@gmail. com>
Sent: Monday, January 24, 2022 3: 32 PM
To: Mary Salas < MSalas@chulavistaca. gov>
Cc: Natalie Flores < NFlores@chulavistaca. gov>; Samantha Trickey < SamanthaT@chulavistaca. gov> Subject: Resident Opposed to the Eastlake Psychiatric Hospital - Please vote NO Hello Mayor Salas,
I'm writing to you as a concerned citizen whose quality of life would be impacted by the proposed hospital. I've had more than 2 years to research Acadia Healthcare and I do not believe they are a suitable partner for Chula Vista due to their history of alleged patient abuse and mistreating workers. If Chula Vista does move forward with Acadia then this type of facility should be co- located with supportive services like an Emergency Room.

Before moving to approve this hospital I implore you to ask that Acadia answer a few basic questions.

They are as follows: Why were additional sites for the hospital not vetted and presented per the CUP process even though it' s required? What does the staffing plan for the facility look like? Why did Acadia say that wages would be $ 30per/ hr when nurses make a base pay of $ 46 here in San Diego County? Where is the official management agreement between Acadia & Scripps? To the city I would ask the following: Why was an independent safety analysis not done by the CVPD? In Rocklin California a similar size psychiatric hospital was slated to be built but after an independent PD investigation Police found that the proximity of the Hospital to schools would not allow schools to properly lock down due to an incident of a patient leaving the premises without permission ( elopement). The difference between Rocklin and Eastlake is that Rocklin' s school was 700ft away from the proposed site and Eastlake' s is only 400ft. Secondly, since the nurses at Scripps are non- unionized how does the city propose we preserve worker' s rights? Acadia healthcare has a history of legal woes that include issues with their own staff and patients. The most recent publicized issue with Acadia and their staff was a 3.5 month nurse strike due to unsafe working conditions caused by understaffing. “ When I heard about a violent patient escaping and injuring 11 of my coworkers, including one who left the facility on a stretcher, I was terrified — but sadly, not surprised.” - Meseret Amare, Nurse What contingency plans will CV have for a potential work outage given that this is such a large high security campus and in close proximity to residents?
In recent months, the city has had issues arising from contracts with multi- billion dollar companies, like Acadia, that put residents last. An example of this would be the Republic Services trash debacle that left the city no recourse due to a poorly written contract as the mayor noted in a recent SDUT editorial piece. However, that contract was constructed by the city. Another recent fumble is the Motorola contract. “ San Diego ACLU lawyer Mitra Ebadolahi contends the overall contract so lopsidedly favors Motorola Solutions that she wonders whether Chula Vista city officials understood the stakes or were simply outfoxed by the company’s high - priced lawyers.” ~KPBSWhat will make the contract with Acadia healthcare any different? I ask that before moving to approve this location the city takes its time in making sure the above issues are settled and questions answered. At the very least, the city should conduct an independent Warning:

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investigation regarding safety for residents, patients and staff as this will be the only high security facility for miles and it happens to border residential neighborhoods and businesses geared towards children. It behooves the city to leverage their vote to have all issues mitigated before moving forward and get Acadia to agree to conditions residents are comfortable with. I for one would like to request that any elopements be reported to the city manager, city attorney and chief of police. Also, if the hospital has 5 or more persons elope that their CUP would automatically be revoked.

I'd like to share with you some research I did through FOIA requests and searching headlines online.

Please see that HERE. Included are headlines and metrics on elopements from hospitals within the county of San Diego. Surely, Chula Vista does not want to be one of these headlines.

Respectfully,
Bibi Luko
619- 504- 2229