At first, the California developer approached the city of Auburn about bringing an assisted living facility to 601 M St. NE, the .78-acre parcel of land between Green Field, the baseball diamond in the northeast corner of Fulmer Field, and the Church of Jesus Christ of Latter-day Saints.
Anybody who wanted to know what an assisted living facility was could read up in state law and find elsewhere an established record of what the communities where they have been established think of them.
But at some point, the Mittman Family Trust of California changed its focus to establishing on the parcel an enhanced services facility (ESF). This entity, which is relatively new to the state of Washington, is for people who have completed their treatment in a state or local psychiatric hospital and are ready to transition to the community, according to the Washington State Department of Social and Health Services (DSHS), which oversees ESFs.
“Our current focus in on finding placements for clients who are ready to discharge from Western State Hospital; development of an ESF along the I-5 corridor is a priority,’ DSHS writes in its literature.
Beyond that, information is a bit of fog – for everybody.
“I’m not going to pretend the city knows exactly what these ESFs are,” Jeff Tate, planning director for the city of Auburn, conceded last week. “We don’t have one in the city right now. This would be the first one.
“What that means is that the state, the city, even the applicant end up getting wrapped around the fence post about how you define it, what term or label to put on it.” Tate said. “We have been in a dance for the last several months with the applicant figuring all of that out.”
According to the DSHS website, the state Legislature authorized the DSHS to develop ESFs. Individuals are referred to an ESF “if they are coming out of state and community psychiatric hospitals or have no other placement option due to their complex behavior, medical, chemical dependency and/or mental health needs.”
While Auburn’s zoning designation there allows residential uses, including group homes and soft light commercial uses, among the latter home-based businesses, the city allows three types of use within each zone, as follows:
• Permitted uses: the applicant applies for a permit, and if what he, she, it or they have proposed is allowed and meets the standards, the city grants the permit;
• A conditional use permit: sets conditions, allows a high level of scrutiny, requires public hearings, and;
• An administrative use permit.
Mittman applied for an administrative use permit (AUP) in July of 2018. At the moment the city is processing that application, and has not granted anything. The public outreach process and notification to neighbors started only Monday.
Unclear at this point is whether Mittman means to build anew or renovate the old, abandoned house on the property.
“While an AUP attaches additional conditions, you don’t have quite as much scrutiny, but you do have care, some security ,and there’s management control of the facility. An AUP gives the city additional ability to scrutinize a use, to determine if it fits into a neighborhood,” Tate said.
Tate added an important caveat: when the proposed use is a group home, the city’s hands would be tied. It could not say who gets to live there, any more than it could direct who gets to live in any other home in that zone.
“There are not many of these. We know the city of Everett has permitted one, and we are trying to learn what its experience was in permitting,” Tate said.
Another may be found in the city of Burien.
Noting the marked difference between ESF patients and those in other types of DSHS housing, including adult family homes, nursing homes and assisted living facilities, Auburn resident Val Erickson, who lives hear the proposed facility, expressed concerns about the change in Mittman’s intended use in a post to the Auburn Reporter.
“The (DSHS) told me that there is ‘a lot of difference’ between ESF patients and those in the other types of DOH housing (adult family homes, nursing homes, and assisted living facilities.) Among the requirements for patient admission are: ‘aggressive, threatening, or assaultive behaviors” that ‘put residents or staff at risk’and are ‘frequent or difficult to manage,’ ‘a history of offenses against a person or felony offenses that created substantial damage to property’; a history of unsuccessful placements’ or ‘rejected applications for admission to other licensed facilities.”
With exceptions, Erickson noted, residents will be free to come and go from the facility into the neighborhood.
In a phone call to the Auburn Reporter, Erickson noted that she doesn’t necessarily object to such a facility coming to Auburn, what she wants most of all is that Auburn residents get a chance to weigh in.
“The ESFs are part of the governor’s plan to replace Western and Eastern State mental hospitals by relocating hundreds of patients in smaller, 16-patient facilities,” Erickson wrote. “There will likely be multiple ESFs in many Washington cities, including Auburn. I hope the city will carefully consider the placement of ESFs in Auburn and involve the citizens of Auburn.” process.”
Here is some of what the Washington State Department of Social and Health Services has to say about enhanced services facilities:
Question: What is the maximum number of clients per ESF?
Q; How many residents per room?
Q: What are the staffing expectations?
A: In addition to on-site medical health professionals and nurses, whenever there are residents in the facility, at least two staff members must be awake and on duty inside the building. When residents are in the facility, there must be at last one staff member for every four residents present.
Q: How long does it take for an ESF to become licensed and contracted?
A: That depends on whether the facility is newly built or converted from a previous use. Other factors to consider are local zoning, unique building requirements, requirements for staff training and local inspection processes.
Q: How much does it cost to license an ESF bed?
A: $1,045 per bed at the time of license application, and $1,040 per bed annually at the license renewal.
Q: What is the daily rate?
Q: Can an ESF be part of another facility or on the same grounds as another?
A: An ESF may hold only one license, but, to the extent that state and federal law allow and Medicaid requires, it may be in the same building as another licensed facility, provided: that it is totally separate and discrete from the other licensed facility; and the two maintain separate staffing, unless the department overseeing it allows an exception.
Q: Are there unique training expectations for ESF staff?
A: Many of the ESF training requirements are consistent with what the state expects of other residential settings that are licensed or certified by the Department of Health’s Residential Care Services. There are, however, four trainings staff must complete before they start working at an ESF. These are as follows: de-escalation training; mental health specialty training; dementia specialty training; and home and community-based services training.