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HEALTH CARE’S FINANCIAL STRAIN SETS IN Even largest systems struggling, which could affect insurance costs BY PAUL SISSON Health systems across the county are scrambling to cut costs and find new revenue sources as increased labor and supply costs fray bottom lines. Signs of financial stress are starting to nudge into public view at even the largest pro viders, local household names that have generally been prof itable enough to shrug off market fluctuations. Last week, University of Cali fornia health providers in San Di ego and across the state worked to avoid a contract lapse, warn ing their patients with Aetna health insurance coverage that they faced losing access as an April 21 deadline loomed. Sharp HealthCare posted a layoff notice for 118 jobs last week, about one month after Scripps Health notified the pub lic that it intends to cut 70 jobs in its administrative ranks. These numbers, said Uni versity of California Los Angeles economist Glenn Melnick, are the current reality in health care. “Health care providers pretty much everywhere are dealing with increased costs at the same time as their investment income is shrinking and they are losing that extra revenue that they got during the COVID pandemic,” Melnick said. “And then you’ve also got to SEE STRAIN • A12
K.C. ALFRED U-T
Inside San Diego’s mental health crisis
T
he mental health system in San Diego County is over whelmed. There are too many people in crisis and too few people to help them. And the situation is getting worse. But what does this public health emergency look like inside the system? For three days last year, The San Diego UnionTribune followed patients, family members, jail guards, clinicians, 911 dispatchers and a host of others to capture a firsthand, minutebyminute account of this suffering. We found a community struggling at every level. During this 72hour period, law enforcement received at least 238 mental health calls from people at transit centers and gas stations, schools and hotels. But most calls came from homes. A subsequent analysis of years’ worth of data showed that the rate at which adults were placed on involuntary mental health holds has nearly doubled over the last three decades. For children, the number has increased almost tenfold. Mental health calls for service to law enforcement have spiked by more than 120 percent since 2009. Out of nearly three dozen police shootings in San Diego County from 2018 through June 2022, 40 percent involved someone with mental health issues. That’s nearly triple the percentage found during the previous 25 years. See our comprehensive coverage of this topic, which includes commentaries by those on the front lines, in today’s 26page section, “72 Hours Inside the Mental Health Crisis in San Diego County.”
SUNDAY • APRIL 16, 2023
IN SCHOOL, U.S. LEAK SUSPECT FOCUSED ON MILITARY
72
Airman may have been posting intel in effort to show off to online pals
HOURS
BY DAVE PHILIPPS, JENNA RUSSELL, JACEY FORTIN & HALEY WILLIS
Above: Patients at Exodus Recovery in Vista. The facility is like an urgent care for people in a mental health crisis. Many were brought in by law enforcement. Nurses evaluate who needs to go to a hospital.
INSIDE THE MENTAL HEALTH CRISIS IN SAN DIEGO COUNTY
For his high school senior yearbook, Jack Teixeira got to pick a quote to appear below the photo showing him smiling in a green hoodie. His choice: “Ac tions speak louder than words.” On Friday, Teixeira, a 21year old airman in the Massachusetts Air National Guard, was charged with two counts under the Espio nage Act because, federal prose cutors say, his actions caused harm to the country he had de voted himself to serving. He did not enter a plea. They said he repeatedly shared classified documents on the Internet through a gaming group he belonged to that fo cused on war, guns, and some times, racist and antisemitic memes. It was a remarkable turnabout for a young man who grew up with a passion for the military and weapons — at times to an unnerving extent, some who knew him said. Teixeira grew up in a family with strong military ties in Dighton, Mass., a town of about 8,000 people near the Massachu SEE LEAK • A9
EXDEPUTY’S SEXUAL MISCONDUCT COST TAXPAYERS $7M That’s how much county has paid to settle at least 18 cases against Fischer BY JEFF MCDONALD The disgraced former San Di ego sheriff ’s deputy remains locked up in a Vista jail cell, with al most no hope of being released un til sometime in December. But while Richard Fischer pays his debt to society for groping, kis sing or otherwise molesting more than a dozen women — many times while in uniform — San Di ego County taxpayers are continu ing to incur more legal costs. In the six years since women began coming forward with allega tions that they were sexually har assed by Fischer, the county has
JOHN GIBBINS U-T FILE
Exdeputy Richard Fischer pleaded guilty to four felonies and three misdemeanors related to onthejob sexual misconduct.
paid more than $7 million to settle at least 18 civil lawsuits filed by his victims. Six other lawsuits remain pending in San Diego Superior Court, records show — legal dis putes in which the county is pay ing to defend him. County records show that at torney Joseph Kutyla, the private sector lawyer representing Fis cher, has been paid just under $1.1 million in public funds since the cases were filed. Kutyla will continue to collect attorney’s fees until the last case is resolved. Neither Kutyla nor San Diego County responded to questions about the payments and settle ments related to the Fischer cases. The attorney representing most of the 37yearold former SEE FISCHER • A14
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