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

Dear B-Town Blog,

Enhanced Service Facilities (ESFs) are a relatively new level of residential care facility. They serve individuals with mental health disabilities who require assistance with day to day activities. They are most similar to Assisted Living facilities. Some in our community worry about the individuals who will reside in ESFs and what siting them here will  mean for Burien.

Burien needs ESFs
Following an unsuccessful attempt to site an ESF in Burien last year, our City Council voted for two consecutive six month moratoriums on the approval of any such site; they end in February. There are currently no plans or requests to site and ESF in Burien. But the need for ESFs already exists, right here in Burien.

According to the National Institute of Mental Health, 18.9% of U.S. adults live with a mental illness and 4.5% with a serious mental illness: https://www.nimh.nih.gov/health/statistics/mental-illness.shtml#part_154784

Only 41 percent of the people who had a mental disorder in the past year received professional health care or other services: https://www.mentalhealthfirstaid.org/2019/02/5-surprising-mental-health-statistics/

Using these figures around 2,340 people in Burien are experiencing serious mental illness, and about 959 of them are receiving no help. Some are in or near crisis, and are still not receiving assistance. In the absence of ESFs, people with mental healthcare needs still return to Burien after receiving acute care – but do not receive the support they need.

Planning Commission review, Jan 8 2020
The commission invited representatives from DSHS to their most recent meeting to answer questions and help them understand who is eligible for residence, the residents’ needs and what services are provided. The DSHS representatives begin their presentations at about 28 minutes into this video: https://burien.vod.castus.tv/vod/?video=09777635-b4cd-4414-b6a4-ef9ebb404450&nav=recent

They also asked our City Attorney to review and advise on the possibility of zoning that would exclude ESFs from proximity to “sensitive areas” such as schools and parks, etc. Her legal opinion is that restrictive zoning violates the Federal Fair Housing Act.  Her response can be found here on page 4 of this document: https://burienwa.civicweb.net/document/33066/Staff%20Memo%20ESF_s%201-8-20%20FINAL.pdf?handle=4A1D1FA868D5456588E23443C6971511
  • Planning Commission Question: Legal questions – The Planning Commission requested that the City Attorney provide comments on the legality of the initial zoning code amendments that included separations from certain uses, namely 330 feet and 660 feet.

  • Staff Response: The City attorney has offered the following opinion regarding ESF and the separation approach:

“There is a definite risk in applying dispersing requirements to ESFs. The reason is that the Fair Housing Act prevents the treatment of an adult family home or adult care facility in a manner that is different from single family uses. While it is too soon to know if an ESF will be governed by the FHA, I see no reason to assume it will not be. In my opinion, the Oxford House body of case law will eventually extend to ESFs, the law just hasn’t caught up yet (Oxford House is a drug and alcohol rehabilitation facility and sued many cities and won, claiming housing discrimination based on disability). In my opinion, if the use can be mitigated through development and working with the property owner or ESF applicant, this would be less risky than a separation requirement.”

State Oversight of ESFs
The Planning Commission Q&A explored how the state oversees these facilities (this discussion begins at 37:48 of the video) and follows up to ensure they are following rules (39:00), and covered changes in regulations that are not yet reflected in the code. At 45:04 in the Q&A the outdated regulations are addressed (at 47:00 – 48:30 the DSHS Representative says that the language in RCW was passed 10 years before funding became available, that the funding is granted through the long term care system and that the population that was envisioned is “absolutely not the population that is being served”)

When residents transition to an ESF from acute care, their discharge plans include medical information for the highest quality of care. The ESF has a residential nurse, who reports any changes in behavior or condition to a physician who dictates the treatment. ESFs are subject to unscheduled state inspections to ensure their safety and the quality of treatment the residents receive.

ESFs do not need special zoning
ESFs require Type 2 approval – meaning there is public notification (https://www.burienwa.gov/business/community_development/land_use_review) for a new ESF. But while the public is notified, the state does not require or recommend special zoning.

Professional/Expert opinion is that restrictive zoning is unnecessary. All evidence based on the data collected from the four ESFs that already exist in Washington State supports this conclusion. Legally and practically, ESFs do not need to be kept at a distance from residential areas, schools, parks or churches nor are there any reasons to restrict  them from single family neighborhoods.

None of the four ESFs currently sited in WA State required special zoning and according to City Staff and DSHS, there have been no reports of issues outside what would be expected from any Adult Care facility. Police and ambulance calls have been for patient welfare, not in response to unlawful activity.

Let’s welcome more mental healthcare options
We talk a lot about not having enough resources in Burien and here is an opportunity to welcome assistance from the State at no cost to our city. People will be getting the support they need to help keep them from relapsing or falling off the edge.

Research concludes that perceived stigma creates a considerable barrier to mental healthcare. (59:59 – 1:02:33)  Mental health issues are already stigmatized enough in our society; instead let’s choose to be leaders in the field, responding to the facts and data and not to fear. Burien has an opportunity to set the tone for other cities in Washington State.

Sarah Moore
Jennifer Fichamba

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