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HomeMy WebLinkAboutEx17_Supplemental_ERC_MemoDEPARTMENT OF COMMUNITY AND ECONOMIC DEVELOPMENT ERC_Aristo_Healthcare_Services_IBHTF_Memo_211028_v1 M E M O R A N D U M DATE: November 23, 2021 TO: Environmental Review Committee FROM: Clark Close, CED Planning, x7289 SUBJECT: Aristo Healthcare Services IBHTF, File No. LUA21-000345, ECF, CU-H Included in the memorandum is some additional information regarding Aristo Healthcare Services Intensive Behavioral Health Treatment Facility (IBHTF). Background The Applicant’s1 proposed IBHTF in Renton is a 16-bed facility that admits resident patients whose primary care need is treatment for a mental health disorder, intellectual disabilities, or developmental disabilities. IBHTFs are a new class of mental health care facility defined in Chapter 71.24, RCW2, designed as part of the state’s plan to rehabilitate persons that are transitioning out of state and local hospitals. IBHTFs were introduced by the Governor’s Office and authorized by the legislature. IBHTFs offer a community-based, home-like environment where individuals with mental health diagnoses can reside in a group setting while engaging in psychosocial rehabilitation. The concept for the IBHTF came from an analysis of the state hospital discharge barriers. The Health Care Authority’s (HCA) Division of Behavioral Health and Recovery (DBHR) worked with Departments of Social and Health Services (DSHS) and the community to identify barriers to discharging people from state hospitals and ensuring they are successful after discharge. From these analyses it was determined there was a need to support people who are no longer benefiting from the treatment at state hospitals but still require more intensive support and treatment in the community to be successful. DBHR consulted with Aging Long-Term Support Administration (ALTSA) and the behavioral health administration (BHA) to develop the facility. DBHR created a proposal for the facility among many other options in a decision package to the legislature. The legislature chose the facility and instructed Department of Health (DOH) to create a license for the facility in 2SHB 1394 and funding for the creation of four (4) facilities in the operating and capital budgets. 1 A healthcare company, Aristo Healthcare Services (“Applicant”), located at 4500 9th Ave NE, Seattle, WA, 98105, on behalf of Aristo Healthcare Services, LLC. 2 A community-based specialized residential treatment facility for individuals with behavioral health conditions, including individuals discharging from or being diverted from state and local hospitals, whose impairment or behaviors do not meet, or no longer meet, criteria for involuntary inpatient commitment under chapter 71.05 RCW, but whose care needs cannot be met in other community-based placement settings. Environmental Review Committee Memo Page 2 of 3 October 28, 2021 ERC_Aristo_Healthcare_Services_IBHTF_Memo_211028_v1 Intake Elements of IBHTF include three components: 1. Comprehensive intake procedures, 2. Documenting a clinical need, and 3. Documenting that the individual does not meet exclusion criteria According to the Tool Kit for Implementing WAC 246-341-1137, residents for the facility need to complete an intake when they take up residency. A best practice would be for members of the treatment team to outreach and start building a relationship before the resident comes to the facility. This will make the transition period easier for the resident and staff. The initial intake will need to be completed by a mental health professional (MHP) and can be completed prior to the person taking up residency. Exclusion Criteria IBHTFs may not serve (1) an individual who is under 18 years of age3; (2) for whom a mental health disorder is not the primary care need4; (3) who have a diagnosis of dementia or brain disorder and can more appropriately be served in an enhanced services facility or other long-term care facility; or (4) who cannot perform activities of daily living without direct assistance from agency staff. Staffing An IBHTF must have personnel policies and procedures that ensure they can provide core clinical and psychosocial rehabilitation services, in accordance with the individual care plans of every individual served. At minimum, the IBHTF must demonstrate that it has sufficient numbers of appropriately trained, qualified, or credentialed staff to provide: 1. Psychosocial rehabilitation related to activities of daily living, social interaction, behavioral management, recovery, impulse control, self-management of medications, and community integration skills; 2. Service coordination by a mental health professional; 3. Psychiatric services, specifically a. 24/7 psychiatric nursing coverage; b. Access to a licensed prescriber (psychiatrist, psychiatric ARNP, or PA); and c. A mental health professional accessible 24/7 and onsite 8 hours per day; 4. Access to intellectual and developmental disability services provided by a disability mental health specialist or person credentialed to provide applied behavioral analysis; and 5. Peer support services provided by certified peer counselors. IBHTFs must have a psychiatric care provider (PCP) who is a licensed prescriber of psychiatric medications available on call, as needed. The PCP can be a psychiatrist, psychiatric advanced registered nurse practitioner (ARNP), or physician assistant (PA) operating within the scope of his or her practice certifications in the State of Washington. A MHP must be onsite 8 hours per day, 3 See WAC 246-341-1137(3)(a). 4 Although they may also admit individuals who have a secondary diagnosis of intellectual or developmental disabilities. Environmental Review Committee Memo Page 3 of 3 October 28, 2021 ERC_Aristo_Healthcare_Services_IBHTF_Memo_211028_v1 7 days per week, and must be accessible 24/7. MHPs function as the primary mental health providers in the IBHTF. The role of the MHP is to provide psychosocial rehabilitation, counseling, care planning, and service coordination. They are responsible to ensure the completion of the initial intake and service plan, ongoing service plan updates, and crisis plans. MHPs will provided therapeutic interventions and psychosocial rehabilitation that are appropriate for the residents. MHPs will work with nursing staff to help build skills for residents to manage medications and their own wellness. At all times, the IBHTF must have two staff awake and on duty. The required psychiatric nurse and mental health professional (if onsite) count toward this total. Staff are not required to be certified as nursing assistants. Minimum workforce for Aristo Healthcare Services IBHTF are as follows: Day Shift Full Time Employee (FTE) 1 on-call Primary Care Physician (PCP) N/A 1 Mental Health Professional (MHP) 1.4 1 Registered Nurse (RN) 1.4 1 Certified Peer Counsellor (CPC) 1.4 1 Mental Health Certified Professional (MHCP) 1.4 1 Program Manager (Mon – Fri) 1 1 Program Support Staff (Mon – Fri) 1 1 on-call/part-time Substance Use Disorder Professional (SUDP) N/A Swing Shift Full Time Employee (FTE) 1 MHP 1.4 1 RN 1.4 1 CPC 1.4 1 MHCP 1.4 Night Shift Full Time Employee (FTE) 1 on-call licensed MHP N/A 1 RN 1.4 1 MHCP 1.4 1 CPC 1.4 Total FTE 17.4 Secure Facilities for Living Facilities are required to implement secure facilities for living, including but not limited to, maximizing safety interventions, security, and support recovery would be achieved through staff training, collaboration with local first responders and emergency personnel, and an engaging treatment program. For example, limited egress through implementation of delayed and monitored egress to ensure the safety of residents in the facility and 24-hour staffing to support residents.