[EDITOR’S NOTE: The following is a Letter to the Editor, written by a Reader. It does not necessarily reflect the opinion of The B-Town Blog nor its staff:]

Concerned Seahurst Residents’ Response to Recent B Town Blog Article: “Open House for proposed new Burien mental health care home will be Jan. 10”:

Dear Editor,

Seahurst residents and local parents are concerned misinformation and a lack of adequate disclosure has skewed perceptions of the proposed Enhanced Services Facility (ESF) at 2108 SW 152nd Street in Burien (proposed site).

WE URGE COMMUNITY MEMBERS TO ATTEND THE JANUARY 10, 2019 OPEN HOUSE AT NOBLE HEALTH CARE’S PROPOSED ENHANCED SERVICES FACILITY SITE FROM 5:30 PM to 6:30 PM AT: 2108 SW 152nd STREET.

What Is An Enhanced Services Facility And What Are The Admission Criteria?

The planned facility at the proposed site, as controlled by RCW 70.97, is not simply a “long-term care home for individuals whose mental health needs make it difficult for them to thrive in a traditional nursing home/assisted living” as stated by Noble Healthcare. What Noble Healthcare is proposing is an ESF, for individuals with mental health needs that also have a history of behavioral and security issues. In order for an individual to be admitted to an ESF, per Revised Code of Washington (RCW) 70.97.030, they must meet two or more of the following criteria:

  • (a) Self-endangering behaviors frequent or difficult to manage;
  • (b) Aggressive, threatening, or assaultive behaviors that create a risk to the health or safety of other residents or staff, or a significant risk to property and these behaviors are frequent or difficult to manage;
  • (c) Intrusive behaviors that put residents or staff at risk;
  • (d) Complex medication needs and those needs include psychotropic medications;
  • (e) A history of or likelihood of unsuccessful placements in either a licensed facility or other state facility or a history of rejected applications for admission to other licensed facilities based on the person’s behaviors, history, or security needs;
  • (f) A history of frequent or protracted mental health hospitalizations;
  • (g) A history of offenses against a person or felony offenses that created substantial damage to property.

The above criteria are concerning, especially considering the proposed site’s proximity to other vulnerable populations already existing in the Seahurst neighborhood:

  • Creative Steps: 528 feet from proposed site (for children 18 months-3 years old)
  • Creative Minds Academy: 276 feet from proposed site (for children 3-6 years old)
  • St. Francis of Assisi School: 292 feet from proposed site (475 students from Kindergarten to 8th grade)
  • Franciscan Apartments: 528 feet from proposed site (62 years old or older- or- under 62 and disabled)

The proposed site is near the following well patroned Seahurst businesses:

  • Seahurst Post Office: 46 feet away from proposed site
  • The Bean: 128 feet from proposed site
  • Lollipops Consignment Shop: 217 feet away from proposed site
  • Bistro Baffi: 397 feet away from proposed site

Additionally, the proposed site is seated in a residential area; the majority of whom are home owners:

  • 10 feet from the closest Seahurst residents
  • 250 feet from dozens of Seahurst residents
  • 1,000 feet from over 100 Seahurst residents

The corner of SW 152nd St and 21st Ave SW is widely regarded to be a Seahurst “Safe Zone”. Dozens, if not hundreds, of children walk past the proposed site to and from school daily. Some of those same children often hangout at The Bean or Lollipops after school. Hundreds of other community members are regulars at The Bean. Hundreds of community members patron the Seahurst Post Office. These are all neighborhood commercial businesses that Seahurst residents see as safe places for our families and children. The proposed ESF does not provide the same comfort.

Concerned Seahurst Residents Do Not Believe the Proposed ESF Is In Line With the Neighborhood’s Character:

The City of Burien has decided that the proposed ESF by Noble Healthcare meets the definition of a Community Residential Facility II and is aiding in their request to rezone the proposed site to “Mixed Use”, which would allow Noble Healthcare to use the facility as an ESF, if there is an office separate from the residential portion of the establishment. Rezoning may set a precedent and unintended consequences for future City of Burien zoning capacities.

The proposed site is currently zoned Neighborhood Commercial (CN) which is zoned specifically for “small areas to provide convenience goods and services to meet the everyday needs of the surrounding residential neighborhoods, while protecting neighborhood character.” (City of Burien Memo to Noble Healthcare; PLA 18-2784. 11/29/2018. [Memo]. pgs. 1-2). Obviously, the proposed ESF does not meet the CN criteria.

As The City of Burien so eloquently states, “The residents of Burien foster civic pride in the beauty and accomplishments of its heritage, and encourages the restoration and preservation of its historic sites.” (Memo pg. 3)

Although The City of Burien has stated that “there is no known historic or cultural preservation site located on the property” (memo, pg. 3), Seahurst residents see the proposed site as part of “Olde Burien”. The historic Seahurst Post Office (and former candy store) has been a Seahurst landmark for over 85 years. The Seahurst Pharmacy, Olde Shell Gas Station (The Bean), St. Francis of Assisi Parish (Established 1929), and the last stop of The Toonerville Trolley are some of the historic and cultural characteristics that the Seahurst and larger Burien community revere.

With Regard to Initial Responses to Noble Healthcare’s 12/2018 Letter By Seahurst/Burien Residents and Noble Healthcare’s Rebuttal In The B –Town Blog:

It is true that Noble Healthcare is not purposing a drug treatment facility or half way house, but neither is this simply a “nursing home” or “long term care facility”, which are controlled by different Washington State laws. This is an ESF for psychiatric patients with behavioral and security issues.

Although Noble Healthcare’s sincere desire to service an underserved population is not doubted; their lack of candor and withholding of essential information to the community in their disclosure letter is questionable and concerning. Through misleading wording in their 12/10/18 letter, Noble Healthcare neglects to disclose their introduction letter as “soon to be neighbors” and invitation to a “meet and greet” were prompted at the direction of The City of Burien:

“We strongly recommended a neighborhood meeting to present your project to the neighborhood residents and property owners before the Notice of Application is mailed. This will help dispel any negative ideas or rumors of what an enhanced service facility is. If not a meeting, then an informational mailing with contact information that they can call if they have questions.” (Memo pg. 4)

Noble Healthcare states that the residents of the ESF at the proposed site will be “coming out of state and community psychiatric hospitals” and will “struggle with issues like advanced dementia, developmental disabilities, brain injuries, schizophrenia, bi-polar disorders, personality disorders, and anxiety disorders.” What Noble Healthcare omits is that residents will have two or more of the following frequent or difficult to manage issues: “self-endangering behaviors”, “aggressive, threatening, or assaultive behaviors”, “intrusive behaviors that put residents or staff at risk”, “likelihood of or unsuccessful placements in a licensed or state facility based on the person’s behaviors, history, or security needs”, “a history of offenses against a person or felony offenses that created substantial damage to property”, “complex medication needs…include[ing] psychotropic medications”, “history of frequent or protracted mental health hospitalizations.”

Noble Healthcare indicates that “being so close to schools will most definitely be a major consideration in evaluating potential residents” (December 2018, B Town Blog) and go so far as to say that they have children living in the same community as their other facilities. It is important to note that the other two facilities that Noble Healthcare operates are not ESFs, which makes the claim by Noble Healthcare a false analogy. Noble Healthcare does “currently operate two care centers – one in Tekoa, Washington [Tekoa Care Center & Retirement] and the other in Cashmere [Cashmere Care Center].”

Tekoa Care Center & Retirement is a retirement Senior Nursing Care facility. It has 55 “deficiency” penalties listed since Noble Healthcare took ownership in 2016, the bulk of which (20) are from 2018 (https://projects.propublica.org/nursing-homes/homes/h-505415).

Cashmere Care Center is a Retirement Senior Nursing Care facility with 7 “deficiency” penalties listed since Noble Healthcare took ownership in 2018 (https://projects.propublica.org/nursing-homes/homes/h-505151)

An ESF appears to be a new venture for Noble Healthcare, derived from the nature of Noble Healthcare’s established business and the fact that there are only four existing ESFs in the state. There is one in Everett, two in Spokane and one in Vancouver (https://fortress.wa.gov/dshs/adsaapps/lookup/ESFLookup.aspx). This is concerning, as there is not a lot of data as to the efficacy of ESF facilities. However, there are troubling “deficiencies” noted in two of the more established ESFs, which includes:

  • Failure to report a missing resident (“walk away”).
  • Inadequate background check of staff.
  • Failure to test for Tuberculosis.
  • Failure to provide staff with adequate de-escalation training.
  • Failure to recognize and account for circumstances related to infection control.

It would appear that despite ESFs being established in legislature since 2005, they are still in the developmental phase.

ESF Security Concerns:

Security concerns for the proposed site include no planning for multiple security layers or secure perimeters. Although ESFs “shall provide an appropriate level of security for 36 characteristics, behaviors, and legal status of the residents” (E2SSB 5763.SL p. 58, & RCW 70.97.060) there is no publically published standard for security.

ESFs are regulated internally by the Department of Social and Health Services (DSHS). External oversight for an ESF is regulated by Department of Health Construction Review Services and The State Fire Marshal’s Office. Under requirements of the Fire Code and by the Fire Marshall, the proposed facility’s doors must remain unlocked during business hours.

Oversite by DSHS does not inspire an abundance of confidence. All one must do is search “WA DSHS” or “DSHS Lawsuits” in the news tab of their preferred search engine for examples of DSHS’ gross negligence. Or one might simply explore Western State Hospital’s decertification by the Centers for Medicare and Medicaid Services, due to their failure to achieve “substantial compliance”. Decertification came after repeat violations that inspectors said put patients and staff at risk, including violent assaults, and the 2016 escape of two high-risk patients and scores of unauthorized patient “walkaways.” (http://www.nwnewsnetwork.org/post/western-state-hospital-lose-certification-53-million-federal-funding). The same DSHS tasked with monitoring ESFs are responsible for monitoring care at Western State Hospital.

More concerning are bills set to go before the legislature when the new session begins on January 14, 2019. As reported by KIRO 7 News Staff on January 4, 2019, Senator Steve O’Ban of Tacoma “has pre-filed two bills to be taken up when the state legislature opens its session later this month restricting which patients from Western State Hospital and the state’s sex offender treatment program on McNeil Island can be placed in adult family homes…The proposal states people with self-endangering behaviors that are frequent or difficult to manage, have aggressive, threatening, or assaultive behaviors — and intrusive behaviors that put residents or staff at risk — must instead be placed in enhanced services facilities based around the state.” (https://www.kiro7.com/news/south-sound-news/senator-seeks-to-stop-violent-offenders-from-being-released-into-communities/899130519)

However, Senator O’Ban’s intentions seem to provide a solution to placing such persons in residential neighborhoods. Unfortunately, theory and practice appear to be two different things in the case of the proposed Seahurst ESF. Even if Noble Healthcare aims to only serve a specific population set within the ESF criteria now, there would be nothing within the current RCW, WAC, or City of Burien law that would prohibit them from changing course in the future. As a private for-profit business, it would be their right to do so.

Equally concerning, per RCW 70.97.220, even though Noble Healthcare is a private for-profit company, because they receive State and Federal monies for their services, they are waived of civil or criminal liability for performing its normal duties, save for duties not performed in good faith or proven to have been performed with gross negligence.

Noble Healthcare’s Proposed Enhanced Services Facility Is Not Appropriately Sited:

It is important to emphasize that Enhanced Services Facilities are of the utmost importance to the wellbeing of its residents and their families, as well as to Washington State’s population as a whole. Mental health reform is one of few bipartisan issues in Washington State politics. However, it is equally important that local government be prudent in serving the public interest and siting such facilities where it is sustainable and protects the public and its existing residents.

The proposed site for Noble Healthcare’s Enhanced Services Facility is not appropriate. The facility would be better served in a more maturely populated area not immersed in a residential community with a large vulnerable population heavily comprised of the elderly and families with children. The proposed site does not provide the multiple security layers and perimeters ideal for the population that Enhanced Services Facilities aim to serve. There is nothing in the legislation that states Enhanced Services Facilities were ever indented to be sited in a school zone with two pre-schools, and a K though 8 elementary/middle school, in the heart of a richly historic community. The legislature defers to its local governments to decide where such facilities are situated. The Concerned Residents of Seahurst will welcome an Enhanced Services Facility to the City of Burien, but with more thoughtful consideration to the appropriateness of its location.

We strongly encourage The Burien City Council to review their city ordinance with regard to Enhanced Services Facilities. The Lakewood City Council recently (April 16, 2018) addressed zoning ordinances to regulate Enhanced Services Facilities due to concerns about public safety. The ordinance before the council amended its city code to prohibit Enhanced Services Facilities in certain residential zoning districts and allow it in others. We encourage The Burien City Council to allow common sense to prevail by acknowledging that Noble Healthcare’s proposed Enhanced Services Facility is not appropriately sited.

Sincerely,
Nicole Cary
(on behalf of Concerned Seahurst Residents)

WE URGE COMMUNITY MEMBERS TO ATTEND THE JANUARY 10, 2019 OPEN HOUSE AT NOBLE HEALTH CARE’S PROPOSED ENHANCED SERVICES FACILITY SITE FROM 5:30 PM to 6:30 PM AT: 2108 SW 152nd STREET.

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