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85-1509 `NHITE - CITV CLERK PINK - FINANCE G I TY OF SA I NT PA IT L Council CANARV - OEPARTMENT � 7 p�/J BLUE - MAVOR File NO. ` �v � � - � __� Co cil Resolution Presented eferred To '� l� ��=�—d�rn�� Committee: Date �� Out of Committee By Date WHEREAS, the City of Saint Paul Council finds that the Saint Paul Planning Commission has reviewed and commented upon the Ramsey County Corrr�nnunity Human Services Department Plan for Overconcentration and Dispersal of Residential Treatment Facilities and recomnends that the Council encourage the Ramsey County Board to adopt this document as a necessary first step toward a fair and equitable solution of the joint city - county problems with respect to the regulation of Community Residential Facilities within the City of Saint Paul ; and WHEREAS, the Council is aware of the intent and purpose of Chapter 617 �linnesota Session Laws of 1984 to protect both the interests of persons served by human services providers, and the residents of the community; and WHEREAS, the Council is equally aware of the potential detriment to the residential fabric of neigborhoods within the city which may result from over- concentration of treatment facilities created to foster the de-institutionalization of our society's less fortunate members; NOW THEREFORE BE IT RESOLVED, that the Saint Paul City Council encourages the Ramsey County Board to adopt and implement the Ramsey County Plan for Over- concentration and Dispersal of Residential Treatment Facilities as an appropriate first step toward the solution of this joint city - county problem; and BE IT FURTHER RESOLVED, that the Council encourages a continuation of open communication and the spirit of cooperation between the City of Saint Paul staff and Ramsey County staff responsible for the regulation of such facilities, in an effort to achieve fair and equitable solutions to the problems of both agencies with respect to regulation of Community Residential , or Residential Treatment facilities. ► COUNCILM N Requested p rtment of: Yeas .�iVN Nays � ,_�- �- � °'ew In Favor Masanz 111sesi� sche�be� __ Against BY Tedas�� Wilson NOV 1 � 1985 Form Appro d y i orney Adopted by Council: Date Certified P• e Council , cretary BY gy, ! dlppr ve by lflavor: Da _' V 1 � 1985 Appr r for Submission il By BY ��;�� v 2 3198� PED - Planninq Division __ DEPARTMENT �°`��NO 264r . Chuck ""cGuire CONTACT 929-13 7 Ext. 313 PHONE August 19, 1985 DATE �Q,/�� ,. Qr A GN NUMBER FOR ROUTING ORDER Cli All Locations for Si nature : epartment Director _ James Bellus 4 Director of Management/Mayor Finance and Management Services Director ty Clerk Budget Director � Riechert � City Attorney WHAT WILL BE ACHIEVED BY TAKING ACTION ON THE ATTACHED MATERIALS? (Purpose/ Rationale) • The majority of residential treatment facilities, regulated under our Zoning Code as "Corr�nunity P.esidential Facilities" fall in part, under the regulating authority of the Ramsey Coun�ty Community Human Services Department (PCCHSD) . This agency has proposed a plan for dispersal of sucM facilities from areas of the City which are "overconcentrated" under the definition of Chapter 617 Laws of P'innesota 1984. While our review of this plan indicates that more work needs to be done to solve our problems in this complex area for regulation, the adoption of the Plan by the Ramsey County Board appears to be an appropriate first stop toward the solution of our joint problems with these facilities. COST/BENEFIT, BUDGETARY AND PERSONNEL IMPACTS ANTICIPATED: RECEIVED Not appl i cabl e � A�� Z �I�� ( � 2 1985 �ITY ATTORNEY FINANCING SOURCE AND BUDGET ACTIVITY NUMBER CHARGED OR CREDITED: (Mayor's signa- ture not re- Total Amount of Transaction: Not applicable quired if under $10,00Q) Funding Source: Activity Number• RCG�i�;',�� ATTACHMENTS (List and Number All Attachments) : A��G �' ;y�� 1 . Draft cover letter from Mayor to City Council �'�A,YGR'; L�r,�f,�,: 2. Planning Commission P.esolution 85- 59 3. Staff inemorandum to Zoning Committee dated July 18, 1985 4. Staff inemorandum to Zoning Committee dated June 13, 1985 5. Draft resolution encouraging Ramsey County to adopt the Plan for Overconcentration and Dispersal of Residential Treatment Programs and fostering a continuatiai of the open communication and cooperation betu�en agencies charged with regulating those facilities. 6. Copy of the County Plan DEPARTMENT REVIEW CITY ATTORNEY REVIEW �Yes No Council Resolution Required? Resolution Required? Yes No Yes X No Insurance Required? Insurance Suff�cient? Yes No Yes X No Insurance Attached: (SEE REVERSE SIDE FOR INSTRUCTIONS) Revised 12/84 HOW TO USE THE GREEN SHEET The GREEN SHEET has several PURPOSES: 1. to assist in routing documents and in securing required signatures 2. to brief the reviewers of documents on the impacts of approval 3. to help ensure that necessary supporting materials are prepared, and, if required, attached. Providing complete information under the listed headings enables reviewers to make decisions on the documents and eliminates follow-up contacts that may delay execution. � The COST/BENEFIT, BUDGETARY AND PERSONNEL IMPACTS heading provides space to explain the cost/benefit aspects of the decision. Costs and benefits related both to City budget (General Fund and/or Special Funds) and to broader financial impacts (cost to users, homeowners or other groups affected by the action) . The personnel impact is a description of change or shift of Full-Time Equivalent (FTE) positions. If a CONTRACT amount is less than $10,000, the Mayor's signature is not required, if the department director signs. A contract must always be first signed by the outside agency before routing through City offices. Below is the preferred ROUTING for the five most frequent types of documents: CONTRACTS (assumes authorized budget exists) 1. Outside Agency 4. Mayor 2. Initiating Department 5. Finance Director 3. City Attorney 6. Finance Accounting ADMINISTRATIVE ORDER (Budget Revision) ADMINISTRATIVE ORDERS (all others) l. Activity Manager 1. Initiating Department 2. Department Ac�ountant 2. City Attorney 3. Department Director 3. Director of Management/Mayor 4. Budget Director 4. City Clerk 5. City Clerk 6. Chief Accountant, F&MS COUNCIL RESOLUTION (Amend. Bdgts./Accept. Grants) COUNCIL RESOLUTION (all others) 1. Department Director 1. Initiating Department 2. Budget Director 2. City Attorney 3. City Attorney 3. Director of Management/Mayor 4. Director of Management/Mayor 4. City Clerk 5. Chair, Finance, Mngmt. & Personnel Com. 5. City Council 6. City Clerk 7. City Council 8. Chief Accountant, F&MS SUPPORTING MATERIALS. In the ATTACHMENTS section, identify all attachments. If the Green Sheet is well done, no letter of transmittal need be included (unless signinq such a letter is one of the requested actions) . Note: If an agreement requires evidence of insurance/co-insurance, a Certificate of Insurance should be one of the attachments at time of routing. Note: Actions which require City Council Resolutions include: 1. Contractual relationship with another governmental unit. � 2. Collective bargaining contracts. 3. Purchase, sale or lease of land. 4. Issuance of bonds bg City. 5. Eminent domain. 6. Assumption of liability by City, or granting by City of indemnification. 7. Agreements with State or Federal Government under which they are providing funding. 8. Budget amendments. . �, p ��J�-��l CITY O1` SBINT PA.UL -.....:, o�c� o� � czz� comvczi. :..,,.......�, ��.��.« � ' 0 O t e : November 4, 1985 . COMM (TTEE RE PORT TO = Saint Pau 1 City Council F R O M � C o m m i�t e� Q h C i ty Deve 1 oprnent and Transportat i on C1� L�lR W� � 1 iam � . Wi lson 1 . R�o.l�t��y<�ur�tgit�g _ -ttMe. Ramsey County Board to ado��ai��'�mp 1 ement the ��s,�� County P i an for Over- � concentrat i on �rtd '�i�per�sa 1 of`12�s.�'�rrti a 1 Treatment Fac i l.i t f es: (Cornm��e�►�`t"�mni�e,��'-�tpp�va 1 ) ��Z-I- SEVENTH FLOOR SAII�IT PAUL,MINNESOTA SSI02 T�'�. C�i=�� ,5�� lT�o. CITY OF SAINT PAUL 6 o�� OFFICE OF THE MAYOR � iiii'i t"i � � Mo �Q 347 CITY HALL !�6• SAINT PAUL, MINNESOTA 55102 GEORGE LATIMER (612) 298-4323 MAYOR August 20, 1985 Council President Victor Tedesco and Members of the City Council c/o City Clerk Room 386, City Hall St. Paul , P1i nnesota 55102 Dear President Tedesco and Members of the City Council : Attached for your review and action is the recommendation of the Planning Commission for a resolution encouraging the Ramsey County Board to adopt the Ramsey County Plan - Overconcentration and Dispersal of Residential Treatment Facilities and encouraging the continued cooperation between City and County staff charged with the responsibility to regulate such facilities. We are all aware of the potential for problems which arises when trends in the reuse of our older housing stock get out of control . The 1984 State Legislature promulgated legislation to protect both the interests of area residents and the rights of facility clients in the future development of facilities designed to accommodate the de-institutionalization of our society' s less fortunate members. This plan is a necessary first step toward the fair and equitable solution to pro6lems which have arisen from the recent de-instituionalization of state facilities. I support the action requested by the Planning Commission and urge the Council to take quick favorable action on the attached resolution. Thank you for your consideration on this matter. Sincerely Geor e Latimer Mayo GL/CM/mb attachments a�o 46 � � ��.�� , . . VII. Comnunity Residen�tial Facilities . � , . � ' Corr�ni ttee Rep�ort & Adopt Resol ution ; � � � , �° (7��5=i��g .� CITY OF SAINT PAUL INTERDEPARTMENTAL MEMORANDUM • DATE: July 18, 1985 T0: Joseph Pangal, Chairman Zoni ng Corr�ni ttee Members _ � FROM: Planning Staff RE: Ramsey County Plan - Overconcentration and Dispersal of Residential Treatment Programs BACKGROUND � , The above captioned document was published by the Ramsey County Comnunity Human Services Department (RCCHSD) Planning Division in April, 1985 in response to the State Department of Human Services (DHS) Instructional Bulletin #84-86. This Instructional Bulletin was prepared by the State DHS to implement Chapter 617 of the Minnesota Sessions Laws of 1984. Chapter 617 of the Minnesota Session Laws of 1984 defines an area as overconcentrated when the number of persons housed in community residential f acilities exceed 5/10 of one per.cent of the total population of a recognized planning district or other minor civil division. The law as we understand it charges state agencies which issue licenses for community residential facilities to solve the problem of overconcentration through their licensing authority. Since determinations of need and a significant portion of the funding for these facilities is a county responsibility, the State Department of Human Services has directed impacted counties to prepare plans which will deal with the problems of overconcentration. At our request, the Ramsey County Community Human Services Department has withheld seeking county approval of this plan to provide an opportunity for the city to review and comment on the plan. This open review period ended July 15, 1985. To date, no action has been taken on the plan by the Ramsey County Board or the State Department of Human Services to approve this plan. ISSUES Overconcentration of corr�nunity residential facilities is presumed to have a negative impact on our community and its neighborhoods. Although the negative influences of overconcentration are not documented with clear and convincing evidence, strong opposition to the location of new comnunity residential f acilities continues to be voiced at the State Legislature, before the City Council , and at public hearings before the Zoning Corr�nittee and Planning Commission. ' _ ��-��sa � With the notable exception of the Familystyle Inc. facilities located in District 9 in St. Paul, community residential facilities which provide human services for children, the mentally ill , the mentally retarded, and chemically dependent persons, do not appear to be perceived by neighborhood residents as . _ , . a serious threat. Resistance to the location of a corrr�nnunity residential .� f acility in all neighborhoods appears to be highest when the facilities are correctional in nature. �� Our Zoning Code definition of community residential facilities does not differentiate between f acilities licensed by the State DHS, the State - ' Department of Corrections, and f acilities which house persons supported primarily by County Human Services funds but do not require state licenses. This plan deals only with community residential facilities licensed by the State Department of Human Services. The plan does not deal with corr�nunity f acilities which are correctional in nature or unlicensed facilities. PLAN ELEMENTS ,. � A major portion of the plan document is devoted to the provision of f acility descriptions and locational information. This information is provided for all f acilities licensed by the State Department of Human Services within Ramsey County. The f acilities are described by State DHS rule designation. The geographic location and size of each f acility is listed in table form which provides the address, the type of facility, the applicable license rule, and the license size by planning district or other minor civil division. This element provides us with valuable information for evaluating proposed new f acility locations. " The second major element of the plan is organized by target population. This segment provides an overview of each target population, trends irr the care for this group, the constraints and barriers to dispersal of persons in these target populations, and current plans for meeting the needs of the target population within the requirements of Chapter 617. The specific target populations dealt with in the document are (1) mentally retarded; (2) children; (3) mentally ill ; and (4) chemically dependent. The remaining elements of the plan provide an overview of community input to the plan calling for ongoing community involvement; a description of barriers and constraints to the implementation of Chapter 617; general recommendations concerning the location of corrrnunity residential facilities and the dispersal thereof; and a brief county work plan. The work plan element calls for considerable additional planning to move toward the solution of the overconcentration problem. This element sets specific target dates for completion of the necessary detailed plan elements and calls for close coordination and communication with the City of St. Paul and other co►rnnunities in Ramsey County. 9 2 J , �,=�s-��q RECOMMENDATIONS Since the plan was prepared in response to a directive issued by a state agency (DHS) under legislative mandate rather than from recognition of the - � • need to find appropriate solutions to real life problems, staff finds that - this plan f alls short of the city's needs. Clearly, additional work needs to be done in the areas of (1) education of the public, (2) clarification of the �' definitions for community residential facilities, (3) improvement in the regulation of these facilities to assure their equitable distribution within the community, and (4) clarification of the state legislation to remove ' ambiguities and conflicts with other state and federal laws. To this end, staff recorr�nends that the Planning Commission adopt the attached resolution and direct staff to proceed with the actions suggested in our June 13, 1985 memorandum concerning residential treatment facilities. (See Suggested Actions: attached.) Staff further recomnends that a complete inventory of all community residential facilities in St. Paul as defined in Section 60.203(C) of the Legislative Code be authorized/directed, and that consideration be given to- the advisability/necessity ofi defining and regulating f acilities for "offenders" and "ex-offenders" separately from other community residential facilities. CMcG/bq 3 � (�,��s=i,so q SUGGESTED ACTIONS To begin addressing these issues, staff recomnends the following actions.� 1. To smooth the flow of work and enhance communications between c�ity .. staff and providers, the Planning Division should provide an opportunity for a "pre-application conference", to advise providers • of all requirements for obtaining the Special Condition Use permit for a faci lity. 2. To assure that all proposals being considered/heard at public ' meetings held by the Zoning Committee are "real proposals", the staff should not accept an application on any proposal until they have received a "need letter" or "certificate of need" from Ramsey County, if applicable, and a "letter of intent" to issue a license signed by the appropriate State official. 3. To establish a �mechanism for citizen input and provide for accountability,`: the staff and the Comnission should recommend adoption of revisions to the city Legislative Code which: a) clearly state that the Special Condition Use permit is issued to a specific provider for a specific program, and any change in rovider or ro ram re uires a new S ecial Candition Use ermit; b state that violation of the conditions upon which any permit far f acilities is issued, will be grounds for a public hearing to consider revocation of the Special Condition Use permit; and c) the appointment of at least one area resident to the Corrmunity Residential Facility's"Board of Directors. 4. To clarify staff, Planning Commission, and citizens' understanding of applicable State, County and City laws, Ordinances and Rules which regulate Corr�nunity Residential Facilities, the staff should prepare a Flow Chart for review by the Cornrnission and subsequent general circulation. This chart should display all agency authorities, relationships and responsibilities. 5. To assure continuing open communication between City staff and the State and County regulatory agencies which fund, license, and determine need for facility development, the Planning Division should be designated as the City's official "Community Residential Facility Liaison Unit". a 4 , . � � �,��g , , . c�ity of saint paul planning commission resofu�ion . file nur��er = . _ � date WHEREAS, the St. Pau1 Planning Comnission is sensitive to the human rtghts of all persons, and particularly sensitive to the r►eed for provision of � adequate human services to protect the r�ghts and meet the needs of our society's less fortunate members; and WHEREAS, the St. Paul Planning Cortanission is equally sensitive to the needs of St. Paul 's residents for personal safety, security, and the protection of property; and WNEREAS, the St. Paul Planning Camnission recognizes differences between concerns expressed by affected neighborhood residents about facilities _ licensed by the State Department of Human Services and those fac�lities ,licensed by the State Department of Corrections; and WHEREAS, the St. Paul Planning Commission upon its review of the document � entitled RAMSEY COUNTY PLAN - OVER CONCENTRA�'IOM AND DISPERSAL OF RESIDENTI L TREATMENT PROGRAMS fi n s t at �mp ementatian o t �s plan wi11 ea towar a etter a ance between the needs of those in our society requiring supportive human services and the concerns of the City's neighborhood residents for the� protection of life and property, but does not addr�ss these same concerns with respect to the provision of correctional facilities within the community; NOW, THEREFORE, 8E IT RESOLVED, that the St. Pau1 Planning Commission recomnends that the Mayor and City Council urge adoption and implementation of this plan by the Ramsey County Board of Co�nissioners as a necessary . � first step toward the resolution of community problems generated by : overconcentration of residential treatment programs in certain areas of the City of St. Paul , recognizing that continued canmunication and coQperation between City, County, and State agencies irtvalved in the determination pf need, reguiation, and funding of these prorams is vital to achieve a _ balance of human rights for all citizens of our City; and BE IT FURTHfR RESOLVED, that the St. Paul Planning Commission recommends that the Mayor and City Council encourage:the Ramsey County Board of Commissioners to engage in a similar planning effort for community ' facilities providing correctional programs. _ moved by . * . seconded by in favor . . � against____- . , �,�,�s=�,�� 5 ,0: :r� CITY OF SAINT PAUL INTERDEPARTMENTAL MEMORANDUM DATE: June 13, 1985 T0: David Lanegran Members of the St. Paul Planning Comnission FROM: Planning Staf��'� e_--��- RE: Residential Treatment Facilities Issues, Regulation, Overconcentration, Dispersal BACKGROUND During the past six months it has become apparent that citizen concerns and expectations about the location and impact of new community residential facilities within the city are active and increasing. Responding to such issues is often difficult, even when the issues are well defined. Clear policies and procedures can ease this task. Currently, the issues are not well defined and procedures are lacking. "Residential Treatment Facilities" or "Comnunity Residential Facilities" as they are defined in the St. Paul Legislative Code include a broad array of living situations, generally regarded as exceptions to standard residential living situations. By current interpretation, any dwelling place providing housing for persons who require care or supervision by professionals in addition to food and lodging, falls under the definition of "Cormnunity Residential Facility". (See Attachment 1 for complete Zoning Code definition.) These "f acilities" form a large growing segment of a "Social Service delivery system", which provides many services to a diverse group of "clients". Location and operation of these f acilities are influenced by/or controlled by state legislation and licensing, county determinations of need, county and private funding, City of St. Paul zoning and the availability of suitable housing structures which have reasonable access to other needed social service f acilities. Since this "system" is evolving in response to the needs of our society's less fortunate members without fully coordinated planning, it is raising issues and concerns which must be identified and resolved. The City of St. Paul is not a major "social service provider", but the Zoning controls and hearing process which the city uses, put us in a strong position to influence the form, location, quantity, and quality of this growing segment of the social services delivery system. C�i= ��-�.�i Staff research indicates that 44 of the 49 community residential facilities serving seven or more persons, licensed by the State Department of Human Services and the State Department of Corrections in Ramsey County are located in the City of St. Paul . Facilities licensed by the Department of Human Services (DHS) account for 41 of the 44 f acilities. The combined licensed capacity of these f acilities is 1,658 persons. The State Department of Corrections currently licenses only three facilities which f all within this definition. These have a combined capacity of 76 persons. The services provided in these facilities are designed to to serve six general target populations. The three f acilities licensed by Corrections are halfway houses for adult offenders. The DHS licensed f acilities serve children, mentally ill , mentally retarded, physically handicapped, and chemically dependent persons. (A more detailed description and locations of the programs licensed by the Department of Human Services is included as Attachment 2 of this report.) In 1984, the Legislature in response to continued expressions of neighborhood concern adopted Chapter 617 which amends the Minnesota Licensing Act, requiring counties having an overconcentration of facilities to develop plans to promote the dispersal of these facilities. This law defines "overconcentration" as the housing of more than 5/lOths of one percent of the population for a recognized planning district or other minor civil division in areas which have no planning districts, in community residential facilities. Using this definition, niae of St. Paul 's 17 Planning Districts are "overconcentrated". (See Table I below.) TABLE I NUMBER OF COMMUNITY RESIDENTIAL FACILITY SPACES LOCATED IN ST. PAUL BY PLANNING DISTRICT Planning # of Spaces Allowed # of Spaces # of Spaces Over or District Allowed by 1/2 of 1� Present Under the 1/2 of 1% Rule 1 95.6 15 - 80.6 2 126.2 197 + 70.8 3 74.97 77 + 2.03 4 79.95 114 + 34.05 5 128.7 20 - 108.7 6 119 154 + 35 7 60.8 56 - 12.8 g 7g,99 217 + 133.01 9 53.3 372 + 318.7 10 57.26 72 + 14.74 11 62.08 53 - 9.08 12 34.08 0 - 34.8 13 96.6 65 - 31.6 14 104.77 0 - 104.77 15 177.1 40 - 77.1 16 36.19 40 + 3.81 17 16.47 166 + 149.53 Ramsey County Community Human Services Department (RCCHSD) has been directed by the State DHS to prepare a county plan to deal with overconcentration and dispersal of Community Residential Facilities. 2 ��j=/5z�� MAJOR CONCERNS In studying the questions and concerns associated with the development of individual Community Residential Facilities, staff has identified seven areas of major concern. These are: 1. Residents fear the development of Community Residential Facilities in their neighborhood for several reasons. a. Residents fear a potential decline in their property value if a f acility is located near them. b. Residents fear potential hazards to their personal safety if a f acility is located near them. c. Residents do not perceive a clear line of responsibility for correcting problems which may occur if a facility located near them is not properly operated. (With 3 or more governmental agencies involved, who do you call about problems?) d. Residents believe that once a home is converted for this type of use, the right to operate such a f acility is permanent, - goes with the land. 2. Persons proposing development of new Cormnunity Residential Facilities may be exploiting the low level of communication between regulatory agencies by telling each agency what they think the agency wants to hear if it is to act f avorably on their applications. 3. Persons proposing development of new Comnunity Residential Facilities are often unaware of: 1) the special conditions authorized by the Zoning Code for regulation of their f acility, 2) the information they will be required to provide for the Commission's consideration in evaluating a request for a permit, and 3) the need for corrmunity involvement/education and comnunication in selecting a location for the facilities they are proposing. 4. Respective agency responsibilities for the location, funding, program monitoring and regulation of comnunity f acilities are not clearly understood by the affected public, and often may not be understood by either the service providers or by the administrators of other regulatory agencies. 5. Given the current direction of change in the provision of Social Services for the disadvantaged persons in our society it is unlikely that the pressures for continued development of Community Residential Facilities will decline in the foreseeable future. 6. The question of what constitutes "overconcentration of facilities" appears to be substantially unresolved. The current legislative definition is at best an arbitrary number fixed without substantive research and without a clear recognition of social service demographics. 3 � �� 7. "Dispersal of facilities" as a means to eliminate "overconcentration" is beyond the financial reach of providers and funders of Community Residential Facilities. The current approach to the "overconcentration" problem suggests prohibiting any new f acilities in areas already housing more than .5� of the district or area population in Comnunity Residential Facilities, and reducing the size of the largest facilities through attrition, and limited relocation of clients. This approach may be contrary to other provisions of State Law. SUGGESTED ACTIONS To begin addressing these issues, staff recomnends the following actions. 1. To smooth the flow of work and enhance communications between city staff and providers, the Planning Division should provide an opportunity for a "pre-application conference", to advise providers of all requirements for obtaining the Special Condition Use permit for a facility. 2. To assure that all proposals being considered/heard at public meetings held by the Zoning Committee are "real proposals", the staff should not accept an application on any proposal until they have received a "need letter" or "certificate of need" from Ramsey County, if applicable, and a "letter of intent" to issue a license signed by the appropriate State official . 3. To establish a mechanism for citizen input and provide for accountability, the staff and the Commission should recommend adoption of revisions to the city Legislative Code which: a) clearly state that the Special Condition Use permit is issued to a specific provider for a specific program, and any change in rovider or ro ram re uires a new S ecial Condition Use ermit; b state that violation of the conditions upon which any permit for f acilities is issued, will be grounds for a public hearing to consider revocation of the Special Condition Use permit; and c) the appointment of at least one area resident to the Comnunity Residential Facility' s Board of Directors. 4. To clarify staff, Planning Commission, and citizens' understanding of applicable State, County and City laws, Ordinances and Rules which regulate Corrrannunity Residential Facilities, the staff should prepare a Flow Chart for review by the Commission and subsequent general circulation. This chart should display all agency authorities, relationships and responsibilities. 5. To assure continuing open comnunication between City staff and the State and County regulatory agencies which fund, license, and determine need for f acility development, the Planning Division should be designated as the City's official "Community Residential Facility Liaison Unit". 4 ��'s��9 Attachment 1 Community residential facility. One main building on one zoning lot where (1) children; (2) persons who are mentally retarded, physically handicapped, mentally ill , or chemically dependent; or (3) persons who are placed there by a court, court services department, parole authority, or other correctional agency having dispositional power over person charged with or convicted of a crime or adjudicated delinquent, reside on a 24-hour basis in order to receive food, lodging, care, training, education, supervision, habilitation, rehabilitation or treatment they need but which for any reason cannot be furnished in their own home. community residential f acilities include but are not limited to: (1) Residential f acilities which require licensing by the Minnesota department of public welf are under (a) Rule 5, child-caring institutions; (b) Rule 8, group homes; (c) Rule 34, persons who are mentally retarded; (d) Rule 35, inebriate and drug dependent persons; (e) Rule 36, mentally ill persons; and (f) Rule 80, physically handicapped persons; (2) Residential f acilities which require licensing or certification by the Minnesota department of corrections or Ramsey county welf are department including community corrections f acilities and adult halfway houses; (3) Family foster homes and group f amily foster homes licensed by the Minnesota department of public welf are, and foster homes, group foster homes, and corr�nunity corrections foster homes licensed by the Minnesota department of corrections; (4) Boarding care homes and rooming and boarding houses which are recognized by the Ramsey county welf are department or other county welf are department as resources, eligible for public reimbursement, for providing residential services to persons who are mentally ill or chemically dependent; and (5) Rooming and boarding houses which provide services to persons who have been charged with or convicted of a crime and have been placed there by a court, court services department, parole authority, or other correctional agency. Comnunity residential facilities specifically do not include hospitals, prisons and reformatories. Source: St. Paul Zoning Code (Section 60.203C) 5 � Attachment 2 y � ��,3 `-/�� DESCRTPTTON OF F'ACIj.TTTES AND TH IR LOCATION ' . Minnesota Laws of 1984, Chapter b1? requires that counties having an overconcentation of community residential facilities servfng seven or more individuals and licensed by the Minnesota Department of Human Services to develop plans to promote their dispersal. Overconcentration is defined in , this law as a planning district or administrative seabdivision having a combined population in Rule 36, 35, 34, 32, $�, 8 and 5 co^,munity facilities serving seven or more persons that exceeds one half of one percent of its total population. � Ramsey County has 1? defined planning districts constituting the city of St. Paul and 18 municipalities and cities which for the purposes of this plan are defined as se�parate adr�inistrative subdivisions. Three of these municipalities, Spring Lake Park, St. Anthony and �lhite Bear Lake are only ' partially located in Ramsey County. Based on the definitions provided in Minnesota Laws of 1984, Chapter b17, nine of the 17 planning districts within tt�e city of St. Paul and one municipality, Shoreview, are overconcentrated: � The following material provides an overview by type of facility and by - � geographie location the prograrrs currently located in Ramsey County. A more detailed discussion of antici�ated changes and trends for each target population is included in Section III of the plan. Maps of the planning districts of St. Paul and Ramsey County have been included as Attachment 2 and 3 to assist the reader to locate and identify �areas of overconcentration. Readers are again reminded that this listing does not � include such programs as family foster hor,�es, facilities serving six or • � fewer people, or programs licensed by �he Flinnesota Departr�ent of Corrections and Health� and therefore may not be reflective of all facilities/programs located in a particular area. Resid�ntial_ Facilti _s by Rule Deqig��ir,n � � Bules 5 and 8: Shelters� Grou Home�(Rule 8) . and Res�d ntial Treatment � Facilities (Rule 5) �rou�Home (Rule 8) facilities are licensed to serve residents are generally adolescents (12-18) who exhibit acute behavorial, emotional, or family problems that require separation from the family and on-going treatment. Their behavior is not so severe, however, that they are not able to live uithin a cornnunity setting, and attend com�rnunity schools. Our Ha�e at 1089 � Portland (district 8 - 10 residents) is an Indian facility, and is currently the only Rule 8 program in Ramsey County. Cl�ents who use R�idential Treat�nent (fiule 5)centers are 5-18 years old and have more serious or chronic emotional problems that necessitate placement in a self-contained setting where nearly all services are provided on-site. Currently Ramsey County Human Services and Juvenile Corrections staff are _ ,; Source:� Ramsey County Community Human Services Department . . � ��'S=/.3� � authorized to place a child for six months in residential facilities and to request an extension of this treatment to 12 or 18 months requires special , agency and court approval. Services are similar to those offered in group , homes but are more intensive, including an on-site school program and a wide range of Lherapeutic and recreational services. Clients within these facilities may or may not be R�nsey County residents, and sane Ramsey County residents are placed in resfdential facilities located out-of-county. Children and adolescents who use shelters may be infants through age 18, and may be abused, neglected or� delinquent. The ma�ority of shelters in > Ramsey County are family homes, but two residential facilities exist: � Booth Brown House for adolescents at 1471 W. Cor►o (district 10 - 15 beds) , and Arlington House at 70� and 712 Larpenteur Ave. East (district 5 - 10 residents per home). Shelter facilities provide short-term (30 days or less) services, includirg physical care, staff supervision and limited counseling and educational services. The trend has been for increased usage of these facilities as an alternative to long term care. Number of • Licensed �e 5 & 8 . �.rict Seds • o Alternatfve Harnes � 6 15 . 1210 Albemarle , o Arlington House for Boys _ - _ 5 5 10b0 Greenbriar - ' o Bush Memorial Children's Center A�nex 5 10 � ' � 919 Lafond . o Bush Memorial Children's Center. � 16 32 180 South Grotto o Wilder Youth Residence 7 12 . 919 Lafond _ o Juvenile Horizons 8 17 325 Dayton ' o Booth-Brown House 10 12 1471 W. Como Avenue o Hane of the Good Shephard Shoreview 12 Shoreview • , ule 4: Residential Pr��ams for Mentally Retard�Children and Adults Three percent of the population is affected by mental retardation. Persons may vary significantly in age, functioning level., abilities and handicaps. . J ;' � �f%'-�`'?�q Some mentally retarded people may have severe or profound mental retardation coupled with significant physical disabilities and medical problems � . requiring almost total life-2ong care. Others may be able to•move into � � their own independent living situations With minimal follow-up. i ' Some facilities provi�e short-term care �ahile others provide long-term ' support and , pro�rams vary dependent on the needs of the clients they serve. In-house services nay include phys�cal care, teaching daily living skills, counseling and recreational activities. taentally retarded clients ; are also required to attend some kind of day program such as school training, developmental achievement center, or employment. The follcwing is a list of Rule 34 MR facilities. Three of these are licensed additionally as ! B�lalg � .�co�rams for Phv��calt� Ha�aoped Children and Adllts and are ; noted as such. � Number of � Bule �4 Licensed . Li��Cis� Beds o A.I.D. Homes � 15 1975 Wilson . . o Greenbrier Home, Inc: 2 165� 941 Birmingham � . o People, Inc. , � 2 3� i599 Ames Avenue - - - �- (also licensed as a Rule 80) � o Phoenix Residences, 3 54 ' 135 E. Colorado ' , (also licensed as a Rule 80) � o Nekton on Wyoming 3 $ ��5 East Wyoming � . o Mlicklough, Inc.� � 4 100 905 E. 7 th � o Dungarvin, Inc. 6 15 . 1086 Como Place o Greenwood Residence East 6 16 1609 Jackson Street � (also licensed as a Ru]e 80) � o Norhaven Homes, Inc. 6 108 1394 Jackson Street o Nekton on Goodrich 16 $ 917 Goodrich Avenue .�;.' � � C�.��'S isa� ,. � o Lake Owasso •Resfdence ' Shoreview ' 64 Shareview � o Residence Inc. I • Shoreview 8 Shoreview o Residence Inc. II Shoreview 8 Shoreview _ o Northeast Residence White Bear Township 9 White Bear Township Rule 34 and Rule 80 programs are monitored by the Minnesota Department of H�anan Services, the Minnesota Department of Health, and the Ramsey County Community Human Services Department. Fire safety and housing code standards also apply. Funding is provided through F'ederal Medical Assistance (Title XIX) funds. For changes in residential or DAC services, Ramsey County must seek approval from the Commissioner of H�sr,an Services. Rule �5: Residential Progt-ams for� Chemisatly�nendeht�; r��*+� Chemically dependent clients are divided into two populations: those in . the early stage of the recovery process, and those still engaged in harmful use patterns. Most residential progr�ns serve the former group� who are � generally �capable of restoration or development of fully independent functioning. At a given time,an estimated 5-30a of the population is �affected chemical dependency;.' - ' � - � ' Rule �2 facflities provide_only short-term detoxification services (Detox, � � 160 E. Kellogg, district 17 - 55 beds), and short-term counseling. Cheraica2 dependency facilities for adolescents include: . Number of � Licensed . ��fs� Beds o New Connections "A" 13 15 444 Lynnhurst Avenue ' o New Connections 3 15 176 Prospect Blvd. , o New Connections Programs, Inc. g � 73 Leech � Adult Programs include: Rule �5 District Beds o Union City Mission (Sherburne House) . 7 20 � , � � . �. ,`��,; � � . • � � �I� �5—/,52�� 550 Galtier � . o Dayton House �1 (People Inc.) $ 15 � � 565 Dayton Avenue ' o Pellowship Club 9 � 55 680 Steward o Juel Fairbanks Aftercare Residence 11 21 806 North Albert o Twin Town Treatment Center 13 50 1706 University Avenue o Team House 17 36 54 W. Exchange � B�le �6: Resicl ntial Prnarama fnr Mentallv I11 dults Clients who requ�re residential treatment often have difficulty in forming interpersonal relationships, have a ntAr►ber of social problems, and extreme deficits in the skills required for living independently in the community. They may require episodic or long-term care. - Residential treatment focuses on teaching independent living sk�lls, counseling and recreation/socialization. Clients are also encouraged to use _ community resources such as school, day treatme.nt, or drop-in centers. , ..___ _ =The current MI facilities are: - - N�anber of �.icensed • ' �8U1�3� � �. , �jstrict Beds o Petra Howard House tPeople Inc.� 4 14 700 E. 8 th Street . (Also licensed as a Rule 80) � ' o Guild Hall 8 99 � 286 Marshall Avenue : . o Oakland Boarding Home 8 36 � 97 N. Oxford Avenue o Peterka Home 8 15 . 513 Portland Avenue � o Family Style 364 Duke 9 175 367 Duke 9 368 Duke 9 . �. : : �-. ., � � , C0�1=t�J� -/•`J�� 3'�0 Duke � 9 � 37? Duke 9 • . 382 Duke 9 , ' 388 Duke 9 390 Duke 9 395 Duke 9 399 Duke 9 403 Duke 9� ' 497 Palace 9 � 49b Jefferson 9 , ; 333 Oneida � 9 339 Colborne � 9 334 1/2 Colborne 9 375 Colborne 9 381 Colborne 9 387 Colborne 9 o Homestead (P.R. Hillman) 9 398 Duke o Hoikka House 9 116 238 Pleasant Avenue � . � . o Hope Transition Center 10 �0 � ' 1471 W. Como Avenue - ` o Hewitt House (People�inc.) :- 11 22 1593 Heaitt -- - - . _ o Marshall fioarding House 11 10 -__1�l89-91 Sherburne Avenue_--- - - ` o Hayes Have � 15 40 1620 Randolph Avenue ��:<: .� % � � � ��/�� _ l�e�� .� ��e�r�� . . • • ' �� i�' ! - _ .��.a� � �� : � . . , ��t�� .. .� �■ ...,�� -�� =�,�� . �.►�--� ► .., - ► , .�/, . • �p !i °�l '!I�I�I'��l��l��,�� '��=3!�� .f►�,,1� , �, . :� -=��' �I '�� ll�► I� � � �� l t i � ,..1,� �Il��;,Il,l � ,�1 �,/, /� � � / . �� ,� � f,.�j� ��,,��/,�� , .. ,, _ -��, � . � ,�l ►I•• I �! . . � .e �► . �li��'l ��%/l,� �/ . �, . � � �'� � ��t � � � ► � , ��,��,.1 ,�.�f, 1�� U , i. •�.�,�� ' '�� ./► /l l .�,��'/� l�'��i� _ ��,�l�.li�,��!,,,��.�f��j; , � ► ► ��, � .s1�/.�.,,:� ,�1 �f��//�///l,%/l.� _ - �v�� r �� -! .. �� ,',:��:�� Q��.�� ;�;;::�;.; .^.�.._�U.�►��v��i�� ► .... .,, ,�,�....,, . .. / ,�• �i� i� .•.i�I �-"7 '�' *!�1 ,�� .� * - _/.��!/�l��.� '��,,�;!r�� ,,�.. . ��i, �� .... �� '�'� `��• ��J �r��c�r.� ��- ��o,� ► � _ �� + `�r� i �� , �/��e�s � � I : ,►�i.I:!�Z!!� " ` ��%'��►��. : �� , er� ` _�.Ge�� - �� , �� y � - / /G,%/. � ��(/l� , r � ,�� ., � � . ��s / . � � ��1S� �O�l.t�I ATTACI�MENT 3 •� � x v.. _,�� . . . .. �,��. MOUNDS . WNITE BEAR y�E{,► NORTH OAKS TO��SH t P � ' ARDEN • 41HITE BEAR � NEI�I H I LLS , LAKE BRIGHTON . / VADNAIS GEM - HEIGHTS LAKE . . LITTLE • � . CANADA ' ROSEVILLE � NORTH - ST. PAU ...,�__. _ _.: . .._. . � ' MAPLEWOOD �'',.: . lAUDER FALCON DALE . HEIGHTS ' , . , ' . � .. - - , ST. PAUL . � IndicatP,s northern Ramsey County municipalities • . � . �= �=�� TABLE OF CONTENTS INTRODUCCICN . . . . . . . . . . . . . . . . . . . . . . . . .• ii I. BACKGROUND & PLANNING PROCFSS . . . . . . . . . . . . . . . . 4 II. DESCRIPTION QF FACILITIES AND THEIR LOCATIONS . . . . . . . . 7 III. THE COPiMUNITY BASED RFSIDENTIAL FACILITIES PICTURE . . . . . . 20 A. SERVICES TO THE h1ENTALLY RETARDED/TARG Ef POPULATION . . . 21 1. A DESCRIPTION OF CHANGES, TRENDS, DEVELOPMENT . . . . . 22 2. UNt�tET NEED FOR RESIDENTIAL FACILZTIES . . . . . . . . . 23 3. CONSTRAINTS/PARP,IERS . . . . . . . . . . . . . . . . . 24 4. METEiODS TO REVIEW BED REDUCTIONIDISPERSAL AND SPr.CIFIC SUGGESTIOtdS . . . . . . . . . . . . . . . . . 25 B. CHILDREN'S SERVICES/TARGET POPULATION . . . . . . . . . . 2Q 1. A DESCRIPTIOI� OF CHANGES, TRENDS, DEVELOPMENT . . . . . 29 2. UNMET NEED FOR RESIDENTIAL FACILITIES . . . . . . . . . 32 . 3. N�I��OD6 US� 'ID SE�C[JRE INP�,T �ARDING OVfl�O�VC�IIRATIC�(/DISPIIZSAL • 33 4. METHODS USED TO REVIEW BED RF.DUCTION/DISPERSAL AND SPECIFIC SUGGESTIOIVS . . . . . . . . . . . . . . . 34 C. SERVICES Ta THE CHEMICALLY DEPENDENT/;ARGET POPUL�TIOId . . 36 1. A DESCRIPTION OF CEiANGES, TRENDS, DEVELOPMENT . . . . . 3b , 2. UNMET IvEED FOR RESIDE(vTIAL FACILITIES . , . . . . . . . 37 3. CONSTRAINTS/f3ARRIERS . . . . . . . . . . . . . . . . . 3�3 4. METHGDS USED TO REVIEW BED REDUCTIONIDISPERSAL AND SPFCI�IC SUGGESTIONS . . . . . . . . . . . . . . . . . 38 D. SERVICES TO THE MENTALLY ILL . . . . . . . . . . . . . . . 40 . 1. A DESCRIPTTON QF CHANG ES, TRENDS, DEVELOPMENT . . . . . 4c 2. UNh1E'I' NEED FOP, RESII?ENTIAL FACILITIES . . . . . . . . . 43 3. CGP7STRAINTS/BARfiIERS . . . . . . . . . . . . . . . . . 47 4. SPECIFIC INPtfi' RECEIVED REGARDING 7,ONING PLAN, DISPEhSAL, OVERCONCENTRATION. . . . . . . .. . . . . . . 48 IV. COMMUNITY If�PUT . . . . . . . . . . . . . . . . . . . . . . . 50 V. BARRIERS & CONSTRAINTS . . . . . . . . . . . . .. . . . . . . . 59 VI. RECQhtt�tEhDATI0N5 . . . . . . . . . . . . . . . . . . . . . . . 60 VII. C011NTY 4JORK PLAN . . . . �:°.- . . . . . . . . . . . . . . . . . 61 BIBLIOGRAPHY . . . . . . . . . . . . . . . . . . . . . . . . . G4 APPENDICE.S . ATTACHMEhTS �j-- �s- �s-a9 INTRODUCTION The document which follows was prepared in response to the guidelines issued by the Minnesota Department of Human Services (Instructional Bulletin 8U-86, Attachment 1) for the completion of a plan relative to the overconcentra�ion and dispersal of community residential facilities. In addition to this document, the Rnmsey County Htaman Services Department has previously prepared a Comprehensive Community Social Services Plan and supporting documents for each of the primary target populations, and has prepared specific work plans for reviewing and modifying on an ongoing basis the current residential care system for individuals who are mentally ill or mentally retarded. The intent of this docunent is to provide a framework for the future ° development and modification in Ramsey County of community residential care facilities serving seven or more people and licensed by the Minnesota Department of E,�anan Services (DHS) to provide treatment and support ' services. The plan does not specifically address other residential programs not licensed by DHS including facilities certified by the Department of Corrections, facilities having six or fewer individuals or � foster homes. In reviewing the specific information in Section II of this � plan, the reader is cautioned to remember that the information provided � does not necessarily therefore reflect all residential services located in Ramsey County. As a framework for future development this plan is intended to be the beginning of an ongoing process that will bring together representatives of the community, consumers, the county, advocacy groups and the cities and municipalities of Ramsey County in a �oint effort to address the provision of community based care and treatment for the citizens of Ramsey County. -ii- � �s�� I. BAGKGROU�JD AND PLqJ9.fVINC PROCFSS Deinstitutionalization, the move to provide the least restrictive living environment for .individuals in need of care and treatment and 'a gradual shift away from larger con�regate living programs has created a need in Ramsey County as in other urban areas to re-evaluate both the type and location of residential services within our community. Over the course of many decades, Ramsey County has developed residential and community based care for individuals who are mentally retarded, chemically dependent, emotionally disturbed or mer►tally ill. While encouraged and contemporary at the time they were originally developed, many of these programs/services a;e no longer consistent with the changing/devel.oping philosophies of treatment and the needs of clients. The develo�xncnt and modification of facilities to appropriately meet the needs of individuals has been corriplicated by a nutnber of issues which continue to ham�er the extent to which these systems are or can be responsive to change. Issues which have in the past and continue today to present obstacles to the smooth and timely development/modification of programs include: o type and extent of funding available has often significantly impacted program design, the size and location of an appropriate physical facility and the availability of support services. As is not unreasonable to expect, the desi�n and operation of a community facility has, as frequently been influended/controlled by what the - funder was willing or able to pay for. . - o allawable or authorized residential treatment approaches frequently have not ee pace with the changing needs of clients or the development of new nodes and €approaehes to their treatment. This results ir� the residential system and funding rrecharisms frequently lagging behind what we believe to be in the best interest of clients. o the cost and investment necessary to deveZop and oper�te physical facilities and the difficulties and costs associated with disbandin� a large, inexpensive program into smaller more expensive units has frequently been seen as prohibitive. If over the long run we are to accomplish a restructuring to smaller facilities, it will require a major cocrrunnitment af public dollars to this effort. o the multiple sources of funding, licensing and control over residential programs has prevented any one jurisdiction or entity � from being able to coordinate the planning of comn;ur�ity based facilities. While the sy�tem is clearly, ar,d we believe appropriately, moving to a client rather than provider driven system, this transition has not and will not be able to occur itr�ediately and may not ever be fully attainable. . -4- � ��=is�9 o comrnunity resistance to location of development of community residential programs particularly those designed to serve seven or , more people has continued to hamper program development. While recent court decisions have helped to clarify what controls may be placed over the development of programs,. we believe that the smooth, orderly change of the residential system will necessitate that puhlic policy regarding comrnunity based care and deinstitutionalization is supported by �ublic policy regarding zoning and "special condi�ion use" requirements. o the existing housing stock most conducive to uses for residential programming and most affordable is located in the older neighborhoods of the city of St. Paul. These are the same areas that are already, however, overconcentrated. o public trans�ortation is not uniformly available within Ramsey County. Public transportation is most widely and regularly available within the city of St. Paul. Other areas have transportation that tends to be mere limited to "rush hours". Public transportation from one area of suburban Ramsey County to nnother is generally unavailable. The availability of transportation is a major consideration in the location of programs where residents are relfant on public transportation. o the historical development of services in metro areas have tended to result in high volumes of use by non county residents. While this has served Lo provide our county residents with a better, more ' complete array of services it has also cdntributed �o the overconcentrat�on of programs in the cities of hiinnea�olis and St. Paul. Any restructuring of the service system to be a state wide system thereby reducing pressure on the metro system is however a ma�or and costly �ffort hampered by the availability of supportive services ��nd transportation issues. The purpose of the plan which fallows is to outline current conditions and anticipated trends within the county of Ramsey and to autline the actions that Ramsey County will take now and in the future to work toward a resider�tial care system that i:� consistent with the intend of Plinnesata Cha�ter 617. Many of the changes outlined in the plan which follow will require changes outside the scope of the county's authority to implement and long range act�on will in rr�ny cases rely on the ability to influ�nce necessary changes in laws, rules and funding to support these pro�ram changes. The pTannin�, process which is bein� used by Ramsey County to respond to the chan�ing needs far con�muniLy based residential care includlrig the need to develop a systc�rnatic plar. for assessing the location of these programs has been develapeci as a multi pur�ose proce�s. �his response has been selected bec�use of the need to address multiple issues _5_ ��'/�q including: o requirements of riinnesota Statute 2�5.812 for the development of a process to evaluate and plan for the d�spersal of existing facilties and to insure development of new programs in areas not already overconcentrated. o need to evaluate and readjust the residential service delivery system for individuals who are mentally retarded in response to the availability of the medical assistance waiver, the ongoing changes in the philosophy of treatment and the changes occurring in the population being served in the community. 0 opportunity given new and potentially expanding options for residential services to the mentally ill to modify the servfce delivery system to better respond to tt�e multiple residential needs of this population. 0 ongoing expansion of resources for the elderly to provide for the development of services both residential and non resi�ential that are more responsive ta individual client need. o a need to minimize barriers to corununity living that discriminate against individuals who have a handicapping condition that prevents them from living totally independer�t. o a need to recognize and balance the needs and concerns of conrnunities with a recognition of the civil rights of handicapped � persons and their appropriate care and treatment. This doct�ent is intended to respond sFecifically to the requiranents of Minnesota Laws 198�, Chapter 617 and has been written as a separate document. Individuals who are interested i� more detailed information regarding specific populations are encouraged to review this document in conjunction with the 1985-86 Biennial Social Services Plan. The preparation of this docunent has involved the input and assistance of numerous individuals who have taken time to meet with our staff, to respond to surveys, to attend meetings and to review and discuss �he information available and our ideas about needed changes. Many of these . individuals have also a�reed to continue to work with us on the ongoing development and implementation of this plan. The details of the input provided is included in the appropriate section of the plan. The survey instruments, the mafling lists and other documents used in this process are included as Appendix A to this plan. _6_ ��--�`�-�s�9 COt�9�;UNITY RFSIDE��TIAL FACILITIES . SERVI�JG SEVEN (7) OR htORE: PERSONS • BY GEOGRAPHIC LOCATION ' M .S j? ADpRESSES LIC��.VSING RULE TYPE OE �'ACILITY LICENSED SIZE Ai, rst i_c , 1 Total - 19,129 .5x � 96 o A.I.D. Hor�es 34 Mental Retardation ,]„�. 1975 trJilson Avenue Total 15 I?istrict 2 Total = 25,241 .5� = 126 o Greenbrier Home, Inc. 34 Mental Retardation 165 941 Eirmir.�ham Ave. o People, Inc. 34 Mental Retardation/ 32 1599 Arr,es Ave. 80 Physical Handicap � , Total 197 District � Total = 14,994 .5p = 75 o NeW Connections "B" 35 Chemical Dependency 15 176 Prospect f3oulevard o Phoenix Residence 3� Physical Handicap/ 54 � 135 East Colerado 80 Mental Retardation o Nekton on Wyaning 34 Mental .Retardation 8 Total 77 District 4 Tctal = 15,991 .5� = 80 � o Petra Howard House 36 Mental Illness 1u (People, Inc.) 80 Physical Handicap 700 East 8th Street o Wicklough, Inc. 34 Mental Retardation .LQQ 905 East 7th Street Total 114 ��strict 5 Total = 25,7u9 .5A = 129 o Arlin�ton House 5 Emergency Shelter 20 . 704 and 712 Larpenteur Av. E. for htinors Total 20 Ri�trict 6 Total - 23:818 .5� = 119. -13- , ��`s=is�9 o Alternative Hcmes, Inc. 5 Child Caring 15 1210 Albemarle Institution � o Dungarvin, Inc. 34 Mental Retardation 15 1086 Como Place o Greenwood Residence East 3� Physical Handicap/ 16 160g Jackson Street 80 hfental Retardation o Norhaven Homes, Inc. 34 Mental Retardation .LQ$ 1394 Jackson Street Total 15� District 7 Total - 13,768 .5% � 69 o Bush Memorial Children's 5 Child Caring 12 Center Annex Institution 919 Lafand Ave. 0 0'St�aughnessy 5 Child Cari ng 12 Institutian o Union City t�ission 35 Chemical Dependency 20 (Sherburne House) 550 Galtier 0 4ijlder Youth Residence 5 Child Caring 12 � 919 Lafond Ave. Institution � � 56 Da strict 8 Total - 15,799 .5� = 79 o Dayton Boarding Care 36 Adult Mental Illness 26 740 Dayton Ave. • o Dayton House ��1 35 Chemical Dependency 15 (People, Inc.) 565 Dayton Ave. o Guild Hall 36 Adult Mental Illness 99 286 Marshall Ave. o Juvenil� Horizons 5 Child Caring 16 325 DaYton Ave. Institution o Oakland Boarding Ilome 36 Adult Mental Illness 36 97 North Oxford Ave. o Our Hc�rne 8 Child Caring 10 1089 Portland Ave. Institution o Peterka Eiome 36 Ad�al t N,ental Il lness 15 -�u- ��s�9 513 Portland t�ve. o Pinevierr 36 Adult Ffental Illness 2� ' 69 N. Milton • Total 239 ��stric� 9 Total = 10,6�t4 .5� = 53 o F'ellowship Club 35 Chemical Dependency 55 680 Stewart Ave. o Familystyle 36 Adult Mental Illness 175 364 Duke 367 Duke 368 Duke 370 Duke 377 Duke 3$2 Duke 3g8 Duke 390 Duke . 395 Duke 399 Duke �03 Duke 497 Palace 4g6 Jeff�rson 333 Oneida 339 Colborne • 339 1/2 Colborne 375 Colbor7e 381 Colborne . 387 Colborne o Hoikka House 36 Adult Mental Illness 116 238 Pleasant Ave. � o ldew Connections Pro�rams 35 Chemical Dependency � 73 Leech Street Total 372 I?istric.� 10 Total = 11 ,453 .5� = 57 o Booth Brown Flouse 5 Child Caring 32 11�71 West Como Ave. Institution o Hope Transition Center 36 Mental Illness .�Q 1471 t,fest Como Ave. Total 72 . District 11 Total - 12,417 .5� = 62 o flewitt House 36 Mental Illness 22 (People, Inc.) . 1593 Newitt Ave. -15- �_ �s%�� o Juel Fairbanks Aftercare - 35 Chemical Dependency � 2t 806 N. Albert � ' o Marshall E�oarding House 36 Adult Mental Illness .1Q 1489-91 Sherburne Ave. Total 53 District 12 Total - 6,969 .5� = 3�+ o None Di'�trj�t 1� Total � 19,328 .5� = 97 o New Connections "A" 35 Chemical Dependency 15 444 W. Lynnhurst Ave o Twin Towne Treatment Ctr. 35 Chemical Dependency SQ 1706 University Ave. Total 65 p},strict 14 Tctal = 20,955 .5� = 105 o None pi,�r ct 1 Total = 23,�422 .5� = 117 o None District 16 Total - ?,23$ .5� = 36 o Bush Memorial Children's Ctr. 5 Child Caring 32 180 S. Grotto Insti�ution o Nekton on Goodrich 3� Mental Retardation �, 917 Goodrich Ave. Total 40 p,�.strict 17 Total = 3,295 .5a = 16 o Team House 35 Chemical Dependency 36 54 West Exchange o Detox 32 Chemical Dependency 50 150 E. Kellogg o Central Manor 36 Adult Mental Illness $Q 2b E. Exchange Total 166 �horeview Total = 17,262 .5� = 86 o Home of the Good Shepherd 5 Child Caring Inst. 36 o Lake Owasso Residence 34 �iental Retardation 64 -16- ��"�J` "�s�'9 o Residence, Inc. I 34 Mental Retardation � 8 o Residence, Inc. II 34 Mental Retardation � � Total 116 bi}�ite Bear ownsh g Total = 6,025 .5� = 30 � o Northeast Residence 3� Mental Retardation ..� Total 9 1ZtZrth St. Paul Total = 11 ,837 .5� = 59 o Bee Dale Apartment� SILS Mental Retardation �? Total 32 *While not specifically covered by this law, this program has been included in the plan because of its size and because it is expected to be included in Ramsey County's' long range plans for dispersal. Arden Hills Total - 8,623 .5� = 43 o None Fal�con Heights Total = 5,�45 .5� = 27 o None Gem ��, Total = 417 .5� = 2 � o None LaudPrdale Total - 417 .5� = 2 o None L.ittle Canada Total = 7,751 .5� = 39 o None �l�wood Total = 28,07 8 .5� - 1�+0 o None Mou View Total = 13,027 .5� � 65 o None 1�eW Brigh�q,� Total = 22,988 .5� = 115 o Nane North Oaks Total = 3,076 .5� = 15 _17_ ��j--��sa� o None � � jtgseville Total = 35,539 .5� = 178 o None St. Anth2nv (part) Total = 2,138 .5� = 11 o None Sp.�in�, La Park (part) Total = 98 .5� = less than 1 o None 11� Heigh_� Total - 7,3b5 .5� = 37 o None {�hj�e Bear Lake (part) Total = 23,�77 •5X = 115 o None �ur�narv � Based on this information and the definitions provided in Chapter 617, the areas � of concern for overconcentration a,e: o District 2 which includes homes for persor,s who have physical handicaps and/or mental retardation (Rules 34 and 80) ; o Aistrict 3 which includes treatmer�t facilities for chemical dependency, and homes for persons wt�o have physi^al handicaps and/or mental retardation Rules 35, 34 and BO) ; o District 4 which includes facilities for �ersons who have mental illnesses and/or physhical handicaps and mental retardation (Rules 34, 36 and 80) ; o District 6 which includes facilities to care for children and persons with ' mental retardation and/or physical handicaps (Rules 5, 3�+ and 80) ; o District 8 which includes facilities for adult mental illness, chemical dependency and care of children (Rules 3�, 35, 5 and 8) ; o District 9 which includes facilities that deal with chemical dependency and adult mental illness (Rules 35 and 36) ; o District 10 which includes facilities for adult metnal illness and child care (Rules 5 and 36) ; o District 16 which includes residences for child care and mental _�g_ ��'�=��9 retardation (Rules 5 and �,4) ; o District 17 which includes residences for chemical dependency and adult � mental illness (Rules 35 and 36) ; o Shoreview which includes residences for child care and persons who are diagnosed as mentally retarded. (Rules 5 and 34). The highest levels of overconcentration as defined by the absolute difference between the number of licensed beds and .5� of the total population are Districts 9, 8 and 17. These districts include downtown St. Paul, the West Seventh Street community and the Summit-University area. Areas which are not overconcentraLed but are close to (within 7Q-15 beds) their level of concentration are Districts 7 and 11. Areas for potential develoXxnent of corununity residential facilities within the county are Districts a , 5, 12, 13, 1%�, 15 of the city of St. Paul and the municipalities of Arden Hills, Falcon f�eights, Little Canada, Maplewood, Mounds View, New Bri�hton, North Oaks, Roseville, St. Anthony, Vadnais Heights, and �dhite Bear Lake (part) . The municipalities of Gem Lake and Lauderdale given their current populations and the definitions of concentration have not been included because their �on�entrat�on leve� is below seven. -�s- �'�,�/5�9 III. THE COt�IUNITY BASED RGSIDENTIAi. F,�CILITIES PICTURE The following information was developed for each target population that make:� use of the residential facilities affected by Chapter 617 of the Minnesota Welfare Licensing Act. These tar�et po�ul�tions include _ individuals who are mentally retarded, children's services, chemically dependent persons, and the mentally ill. The information includes . definitions of target populations, trends in residential services, tiarnnet needs, input gatt�ered from providers and advocates regarding zoning issues, barriers to develo�tnent/or dispersal, and specific suggestions. � -20- ��9 A. Services to the Mentally Retarded � , Target Population Mental retardation is defined as subaverage intellectual functioning which originates during the deve2o�xr�ent period and is associated r�ith . impairment in adaptive behavior. The prevelance of inental retardation is estimated to be 3� in the general population. In Ramsey County (population = 459,784) there are approximately 13,800 persons who are mentally retarded. Nost of these people are able to get along in the community with the help of families, friends, and employers. Many find jobs and are able to live independently. Only the most severely retarded require the protection and daily assistance of the public social services system. The prevalence of severe retardation, as determined by epidemiological studies, ranges from 0.33X to 0.9�, with variations due to differences in definition, age, and socioeconomic factors. Based on these rates, estimates of the number of severely retarded persons in Ramsey County ranges from 1 ,500 to 4,�60. The Ramsey County Htunan Services Department currently is providing services to 1 ,763 mentally retarded children and adults: 0 1 ,159 adults and 326 children living the cammunity 0 278 people in state hospitals. Of the adults who live in the community, approximately 0 19� are unable to perform basic life skills without supervision; 0 17� are unable to communicate so that they can be understood; 0 7� exhibit offensive or destructive behavior; 0 18� perform independent living skills with little or no assf.stance ar reminding; 0 7� are 'borderline' retarded who require continued assistance because of poor judgment, lack of money management skills, or behavior problems. -21- ��`�� Trends in Residential Care Nowhere in the �eneral social service delivery system has the move ' towards deinstitutionalization and the concepts of community based care and least restrictive environment been more widely discussed and implemented than in the provision of residential services to the mentally retarded. Current and pending federal legislation, state law, changes in funding mechanisms, in particular the Title XIX waiver, and the Welsh vs Levine consent degree, have all contributions to a major effort to: o substantially reduce the number of people residing in state hospitals; o encoura�e and perhaps eventually mandate the reduction of very large facilities; and o expand the array of residential options available to adults who are mentally retarded. At the present time, Ramsey County has 14 ICF/MR facilities (Rule 34) serving seven or more mentally retarded individuals. The combined bed capacity of these facilities is 610 persons (See Section IIB) . In 198�+ , the state legislature authorized the Ninnesota Department of Htanan Services to design ways to encourage the voluntary reduction of large facilities. In response to that legislation, the Ramsey County Human Services Department initiated its own �ed Reduction Task FQrce to look at the options available for dispersal of the very large programs/facilities. • Ramsey County presently has three facilities each with 100 plus beds and having a combined licensed capacity of 375 [�eople. Demand for placement in these large facilities by our county case mana�ers has been decreasing steadily over the last few years. At the present time, over �10� of the persons being served in these facilities are from other counties. � 1 . Description of Changes, Trends and Development All of these large residences in the county have considered plans for voluntary reduction, and two facilities have introduced legislation wt�ich will financially allow them to reduce their population. TF�ere is a general agreement among people working with the retarded (parents, professionals and advocates) that large facilities should be reduced, however, since these faci.lities serve over half of the mentally retarded living in the community, any change or plan for reduction will affect the . entire residential system. Given the current approaches to services, new residential services being planned for mentally retarded persons will either be group homes for six people or will be certifi�d as supported livin6 arran�ements (SLAs) and licensed as foster homes for three or -22- ��✓�9 fewer people. The plan for the large community facilities will be to reduce � them over the next. six years by one-thi.rd or approximately 100 beds. This space in large facilities would be replaced by smaller group homes for six people and SLAs. The net result would be a reduction of approximately 100 beds in the three large facillities. This trend can also be showr on the follow.irig chart: CHART J: FACILITY DISTRIBUTION f3Y 1991 CURRENT ST_ZE LICENScD BY FACILITIES BEDS 1991 FACILITIES OVER 100 374 180 BEDS: GREENBRIAR, NORHAVEtJ, WICKLO[�GH SPECIALIZED FACILITIES 166 166 OVER 30 BEDS: PEOPLFS, PHOFNIX, GREEf��lOOU, & � LAY.E C4�IASSO PESIDENCE (CLASS 'B' FACILI'fIES) SMALL GROUP HOt�SES 204 250 (CLASS 'A' ) SFfALL GROUP HOMES 6 106 (CI.ASS 'B') FOR PHYSICALLY HAPJDICAPPF.D SL�s FOUR & UNUE.R . 200 2. Unm�t Need for Residential Facilities ' The top priori ty r��ed j denti f.i ed in the 1985-56 �1.R. pl an i s the develo�xnent nf services for hi�h risk clients. These hi�l, risk �roups i nelucl� persor�:; wi th t�E�l�dv i c,r prot;l cn�,,. auti sm, severe and -23_ �'��9 profound retardation, medical problems, visual and/or hearing impairments, com.munication disorders and offenders. The � residenti�l services required for these high risk groups will ' require 24 hour care, intensive pro�ranuning and supervision and in most cases will require a class. 'B' ICF-MR type facility. In addition, tr�e county must. rcturn 70 people from state hospitals back to the community in the next two years. Most of these state hospital residents (90�) do not have self preservation skills and will require a class 'B' level grou� hane. In order to provide ICF-h;R class 'B" programs for these clients, the county plan ir.c�udes moving as many clients as possible frcm existing small group hor,�es into less restrictive SLA homes for four or less. The county has accepted proposals from three providers to start Lhis mover�ent with 30 clients (by summer 1985) and ;.a continue this process for as many clients as are identified. The vacaneies created by movement of some clients to less restrictive alternatives will be filled by high risk clients; severely and profoundly retarded, hearing impaired ar.d people who have acquired self preservation skil�s. The second part of this plan is to create additional class 'B' group hanes for people currently in state hospitals and needing community placements. At present, we would plan to maintain the 166 beds in class 'fi' facilities and create over �he next three years 16 new ICF-MR class 'B' group homes each serving six people with multiple handicaps. • Given the current approaches to the care of individuals who are mentally retarded it is unlikely that any major development of facilities serving seven or more individuals will occur. 3. Constraints/Barriers Bed Reducti� In order �o obtain apprpv�l for new ICF-MR beds in the cammunity it is necessary to decertify beds in large institutions (state � hospitals or large community facilities). Since current state guidelines specify 'voluntary' decertification, it will also be necessary to institute: o state incentives passed by the legislature to permit large facili.ties to spread their fixed costs over fewer residents while reducin� in size. � o staLe guidelines (or federal) in rule or in law to assure that reduction costs will be shared by both staLe and federal reimbursements in the same proportions as at present. o concentration of services. The presen� legislation restricting -24- a��/`5�9 develapment to 1 ,320 feet between facilities hampers the development of "cluster models" which provide an opportunity for individuals to live close to one another while not being ' co-located in the same building. �lew pey��q�� o Ffany of the plans in pro�ress assume the continuation of the Title XIX waiver implemented by the State of Minnesota in 1984. If as is currently proposed, this waiver is eliminated it wi11 necessitate a complete re-evaluation of the planned changes in particular those plans which are contingent on the availability of funding for non ICF/M� progr�ms. o Many of these new group homes would be appropriately placed in suburban areas, since this lower f:anctioring non ambulatory population will not require public transportation. Support services for these multiply handicapped people will need to be developed in these parts of tPie county and we will need to work with community officiaJ.s to assist in an orderly development of programs. 4. Methods to Review Bed Reduction/Dispersal and Specific Suggestions Mental Retardation Reduction Task Forcee The 1985-86 M.R. Plan (objective 1 .4) calls for the development of a long range plan for the reriuction of large residential facilities by January, 1986. To meet tnis objective the M.R. Planning Team and the M.R. Advisory Committee appointed a task force comprized of: county boarc� apnointed advisory committee members (3) , consumer and advocacy representatives (3) , representatives from residential f'acilities (3) , and two staff members from the Human Services Department. 'I'his task force has met eight times since November of 1984, guests from large residential facilities and cther i�nterested citizens have attended these meetings to hear tFStimony f'rom and review the following reports: o Citizens League Report, 'Meeting the Crisis in Institutional Care' o State Pl.anning Agency, 'Policy Analysis Series' o Ramsey County Human Services, 'Case Mana�ement Issues' and � 'Planning Issues' o Final Report, 'DHS St.ate LJide Bed Reduction Task E'orce' o Reduction Plan from each of the three large facilities. _25_ ��9 o President of Foster Care Association, 'Foster Care as a Residential Task Force' � o Additicnal reports, statistics, and cost estimates. 1Y�e preliminary report of the task force will be completeci by June 1985. This report will be reviewed by the N.R. Advisory Subcomrnittee and by the department and will be presented to the county board as the basi.s for the long range reduction plan to be developed by January 1g86. The three large facilities in Ramsey, in reporting to this task force have expressed an interest in reducirg by 30 to 50p if incentives are provided by the legislature. This reductian would bring all plannir.� distric�s ►�►here M.R. facilities contribute to overconcentration under the percentage limit. � ri��2 Total = 25,241 �.5� = 126.2 o Greenbri.er E3ome, Inc. 34 P4ental Retardation 165 941 5irrriingham Avenue Reduce to: o People, Inc. 34 1�tental Retardatian/ 1599 Ames Avenue 80 Physical Handicap � TOTAL 112 , Uistrict 4 Total = 15,991 a.S� = 79.95 o Petra Howard House 36 Mental Illness/ (People Inc.) 80 Physical Handicap 1�4 700 East 8th Street Reduce to: o Wic�clou�h, Inc. 34 Mental Retardation ;�, TOTAL 79 .p�s ri�t 6 Total = 23,818 0.5� = 119 � o Alternative Homes, Inc. 5 . Child Caring 15 1210 Albemarle InstituLion o Dungarvin, Inc. 34 Mental Retardation 15 • 10F36 Como Place o Greenwood Residence East 3� Pl�ysical Handicap/ 16 1b09 Jackson Street 80 Mental Retardation Reduce to: -26- ��,�9 o Norhaven Homes, Inc. 34 Mental Retardation �$ 1394 Jackson Street ' TOTAL 84 ' The draft plan calls for 'voluntary' reduction and will give these three lar�e facilities time to develop their reduction plans. It should be stressed that these voluntary reduction plans are not likely to be submitted unless some incentive or guidelines is developed by the state. The plan also calls for a county review and acceptance of proposed reduction plans. This is an essential element in planning since the reduction of these three facilities affects over bOp of the people placed in ' facilitiies in Ramsey County. The second �hase of this draft plan calls for facilities serving less than 1�0 people and providing service to a special population to be consider�d in a separate review and plan. These four facilities (Lake Owasso Resi.dence, Phoenix Residence, Poeples Child Care and Greenwood Residence) meet a high priority need, the county will maint�in these facil.ities at their present size until ather reduction plans have been implemented. -27- ��i�9 Bed Redwction Task Force � PurpQSe: To conduct a review of the residential services in Ramsey County, ta identify the i_ssues involved in the changing residential service system and specifically the issues involved in the reduction of large residential facilities in the county. The task force should make reconu��endations to the M.R. Advisory Subco��n�ittee, the Human Services Advisory Committee, and the Human Services Uepartment to be forwarded to the county board when appropriate. TASK FORCE t9EMBERS Amanda Beeldnan Jeff King PEOple's Child Care Residence Real Estate Dynamics 1611 Ames 22b9 Ford Parkway St. Paul, MN. 55106 St. Paul, MN. 55116 77�-59�+0 (0) . Robert Sennett Cliff I��cCann 160 E. Kello�g Blvd. Office of State Auditor St. Paul, b1N. 55101 555 P�rk Street 292�E071 (o) John Buck Skip Sajevik • 6b8 E. Wheelock Parkway Norhaven St. Paul, MN. 55101 1394 Jackson St. Faul, MN. 55117 488-U275 (0) Gwen Dr;.�rmond Floerke Ken Spears 23259 Lofton Court North 105 Car�rel, �207 Scandia, t�(N. 55073 West St. Paul, Mh'. 5511$ �33-3bG9 (H) t�29-76b6 (0) ftichard Eielgeson Robert Voeller SPARC 1577 Chamber Street 65 C. Kellogg IIlvd. , Fim �37 St. Paul, hW. St. Paul, MN. 55101 224-33U1 (0) Sandi Henry FACILITATOR: Dun�;arvin, Inc. Ed Van A11en, Planner • � 905 E. Seventh Street M.R. Services St. Paul, MN. 5510G Human Services Department 774-1165 (0) 160 E. Kellogg IIlvd. , 1�8g0 SL. Pa�a2, MN. 55101 . 298-4619 (o) -28- �"��/3�9 B. Children's Services Target Population � The followin� groups of clients needing residential care are addressed in this F,ortion of the zonirg plan. . o Families with children under age 18 who are experiencing dependency, neglecL, abuse; o Pregnant adolescents (under age 18) ; o Adolescent (under age 18) par�nts and their children; o Children who are dependEnt/neglect�d wards af the state; o Children and adolescents wr�o are anotionall�� dis�urbed. Canmunity based residential facilities for ch�_ldren who are mentally retarded or chemically dependent are �ealt witt� in descriptions of those target populatians. 1 . Description of Changes, Trends and Development Resi�ential and out of home placement services to children have ur,dergone numeraus changes since orphanages took young children off the streets in the late 1EOC's and the first half of the 1900's. Perhaps none of these trends has had as heavy� an im�act on the numbers of children who arr placed �utside their parent's homes than the mavE�nents for family reunification, placement prevention, adoption and placer�ent, when r,ecessary, Lhat preserves the child's reli�ious, raci�l, cultural ard ethnic herita�e. Social scientists, therapists ar�d farnily rights activists, in the last i9f�0's and early 1970's, t�egan to s�udy and write about the implications of foster cure and/or residential out of home place7�ents on children. Classic wor�ks in these areas include: �_I��ion o�f C� r� i n� by Robert Gei ser; In the Best Interes�.� the_C,�,1.�. and fl�.��?��IY��.�� s of the Chil�i by Anna F�eud, et.al. , and the re�earch of John Eowlby in England on the effects of separation ar�d attachment on children's develo�xr;ent, These people stressed the dan�ers. ta the pl�ced child and other family members of prolongcd sep�ra%ion frorn one another and on t.he child from their racial/cultural heritage. Tl�e Oregon Project, sponsoredd by the �e�artment of F;ealth, Education and Welfare • in 1977 and im�lecn��nted �y child welfare a�encies in Oregon beeame a demonstration project outlinin�; the "how to'sQ1 in the gro��ring trend toward perrrianency planning and family reunification. Subsequently, social work �;ractice continued to move in the direetion of' placement prevention� fostered by federal and state laws. . -29- ��`�� Recent child welfare laws that rrsandated culturally religiou:;iy and ethnicly, appro�riate placements, prevention of placements, ' reunification and adoption, inclucle the federal Indian Child Welfare Act, the Minnesota State Flacement Preference Act and Public Laws 96-�272 which is the �ldoption Assistance and Ch91d Welfare Act of 1980. Tt�e force of' these laws has generated 7 family oriented and culturally sensitive national policy focus that discoura�es out of home placement for children, mandates intensive services for placement prevention and reunification and sets up an intensive legislative and administrative review process for all out of home placen:ents lasting lon�er than :;.tx months. These laws have also encoura�ed the develo�xr,ent of family based� in home treatment approaches and thE use of respite care and/or day treatment pro�rarr�s to prevent placement and keep fami.li.es to�et.h�r. Pro�rams like Project Craf t and the work of permanency experts like Vera Fohlberg and Claudia Jewitt havc lead social workers into netii attitudes and practices in the field of adoptions, which are reflective of the desire for permanent families rrithin the child's own cultural heritage for• children and the least restrictive placement alternatives. Ramsey County's placement practices have changed dramatically since the late 1970s. These chan�es have occurred as the result ef chan��s � in the law and changes in philosophy regarding the care and treatment of children. Attachments �l� 5 and 6 from the county's 1985-86 CSSA plan provides a very gr�phic illustration of trends towards decreased useage of Rules 1�4,5 and 8 faci.lities by both the Hur�an Seryices Department and the Ransey County Corrections Department from 1g79 to 1�'84. The Charts which follows gives a picture of R�msey County placement for L•he month T4arch �985. H�unan Community Total of March 1 , 1,�85 �.�ry1�.�s Corrections C.D. & H.Sy � Placc�m�nts Rule 1 � 4 395 13 In county 363 (Farnily Faster Out of county 55 Hon�es) See Out of state 12 Rule 5 41 �5 In county 33 Residential Out of county 39 Treatment Out of state � Rule 8 22 26 In county 3 (Group Homes) Out of county U1* Oui: of state 4 -30- �� The majority of these p�acements are in St. Croix Camp, a facility developed and operated by the Idilder Foundation as a short term � alternative for Ramsey County children. By camparing the figures for out of hor,�e placements, it is � apparent that placement prevention is working in Ramsey County. Usage of Rules 1 and 4, Foster Homes, was at a high of 772 children in placement in April of 1979 compared with 408 children on March 1 , 1985. This decrease is a reduction of 47p of children in foster home placement. In April 1979, there were 220 children in Rule 5 Residential Treatment Centers, compared with a total of 76 children on hlarch 1 , 19E5. This decrease is a 65.5� reduetion in Rule 5 placements. Group home (Rule 8) placements of children reached a high of 81 in Ramsey County in 1982. This figure can be contrasted with the �18 children who were� in Rule 8 placements on March 1 , 19E5. a reduction of 59N. As the numbers of placements have decreased, so too have the number of available beds. Rule 1 and 4 Foster Homes have decreas�d by 357 families since 1978. Rule 5 spaces were reduced in �98� by 14 beds when the Arlington House Treatment Pro�ram closed. Brcwn House currently has one unit of ten beds unoccupied and unstaffed. In additi.cn to bed reductions in these Rules, group home space was reduced by 25 beds when Harambe and Directions for Youth both closed, since 19$1 . � Programs that have developed since 1979 to take the place of these residential facilities include alternative placement services in all Rules as well as non residenti.al day services. Ramsey County has t�ro day treatment programs for adolescents. These pro�rams, the Intensive Day Treatment Progr4m located at 19�o tir. County Road B, Roseville and Family Centered Adolescent Services located at 900 Albion Street, St. Paul, are an alternative to residential treatment placements. These programs have on site schools and intensive therapeutic programming for children and their families. The adolescents who attend these pro�rams remain at home with their families during their involve-tnent. As the number of placements has decreased so too have the number of available beds. Since 1980 the foll.owing programs have closed or have reduced their operating capacity. The facilities which have closed are: � Number of � Lfcenced 12.is�� a.�d� o Arlington House 6 21 , 1060 Greenbrier o Harambe 8 10 896 Marshall _31- �'_�''��/,�9 o Bush Annex 8 10 625 Portland � � o Lincoln House 12 15 1887 Lincoln The facility currently cperating at; less than capacity is: Nwnber of Beds being Licensed 9.y?.�rated o Booth Brown 32 27 - 29 1471 W. Como Avenue Home based services concentrated on placement prevention, use of day treatment and respite �are and intensive family therapy all designed to maintain the child in their home and support family efforts to stay to�ether. Our statistics show that even when placement must cccur, it is of shorter (le�s than three months) duration than before 19�0, and in l�ss restrictive types of settings, most commonly family foster hames, short term shelters, or with extended family r�embers. All of these developments are reflective of needs as discovered in the 19$4 needs assessment and are reflected in the goals of the 1985-86 CSSA Pla� for �'amily and Children's Services (See Appendix B) . This changing picture of decreasing out of home placements is not expected '�o stop. Along with the predicted maintenance/no growth in the number of children in Ramsey County from now until the year 2Q00. We anticipate no need for r�ore bed development of large out of home placement resources. We antici�:ate that any grcwth in facilities will be in Rule 1 & 4 (foster care Y;omes) and Rule 8 (group homes) , licensed for six cr fewer children. The only possible law that could have on impact on this prediction for no new large residential develo�nent is the Aevised Juvenile Code which is presently being introduced in the Minnesota legislature. Article II of this co�e mandates sep�rate detoxification facilities for juveniles. Therefere, if this provision beccme� law, Ramsey Cou;�ty will need to provide this serv�ce. It is antici�ted that the law will not pass this session of the le�islature. However, this provision needs to be watched and planned for if it becomes law. 2. Unmet fdeed for Residential Facilities The largest unmet need in Ramsey County is for the development of placement resources that are culturally sensitive to the needs of the child. At the present time there are three programs that have or are bein�; devcloped to address these needs. Two of the pro�rams are group homes. -32- ��=�� a. An Dai Yun� (Qur Hane) is a ten bed, Rule 8 program licensed by the State of hiinnesota in 1983. The progr�rr� is located on Por�land Avenue and is desz�ned to provide short term crisis int�rvention for Indian children. The pro�r�: operates under the gui�elines of the federal Indian Child 4lelfare Act and is funded through a federal grant. b. A program is in the process of being developEd to provide group home services to n,inority, primarily black yc�uth. The program is currently wor�:ing with the city of St. Paul and the Minnesota Department of Corrections to secure a license to operate. t�'hile the location is not yet f.rm, it is the intention of the developer to atten�pt to locate in the S�rmit University area (an already overconcentrated area) as the most culturally appropriate area to service the needs of thi� group of adolescents. This program will not be covered by the Minnesota Welfare Licensing Laws. c. The third program is a foster care program bein� developed by . the St. Paul American Indian Center to serve R�msey County's native American population. Hemes will be culturally sensitive and located within the Indian community to preserve thE child's heritage in compliance with the Ir.dian Child 4lelfare �ct and Minnesota's Placement Preference Act. In addition to the progra.rns listed above, additional n?eds which have been identified as part of the bienr,ial Flan and which are currently under evaluation include: o dev�lopment of short term crisis intervention programs/respite cre programs for children and families as an alternative ta placement or instiLutionalization. o development of additional capacity to provide independent living skills progr�rns for older adolescents. 3. hiethods Used to Secure In�,ut Regarding Overconcentration/Dispersal In order to secure input from current providers Gnd professionals who utilize existing facilities, copies of the laa� and a series of questians were dis�ri�uted to each of the Rule 5 and 8 provieers, to the Foster Parents Associ�tion, to representatives of community a�;encies on the Children's Planning Team and to m�mbers of the Children's Advisory Subcomrnittee. 1�11 current providers of Rule 5 and �3 services were also interviewed by a staff inember of the Hucnan Ser�tices Departn�ent. The following material sun;marizes their comments and recomnendations regarding overconcentration and dispersal. a. No vendor°s wished to voluntaril y disperse or reduce beds unless there rlere financial incentives to allow them to do so without abs�rbing t.he cost themselves. -33- ��'��°9 b. All Gersons contacted felt that dispersal outside af St. Paul proper would have a heavy impact on residential servjces. Impacts cited included: ' o heavy financial costs to existing providers includin� loss of money in trying to sell big, old buildings and major seLup and purchasing costs in new areas. o many persons felt that Ramsey County would not/could not absorb the higher per diems that would be necessitated by dispersal so fewer kids would get placed "even if they needed it." o the need for development of more adequate transportation services in the suburban areas so that parents could visit and kids could get around especially for jobs. 4. Methods Used To Review Bed reduction/Dispersal and Specific Suggestions a. Other input regarded barriers: . o the biggest barrier cited was money. Most persons felt that costs were prohibitive to relocation and vendors felt that the county could not be helpful with money to defray these costs. o the next largest barrier cited, the higher cost of buildings that • are large enough in the suburbs. Most agencies felt their current location (building size, especially) could not be duplicated in the suburbs at a cost they could afford. o support social and medical services were not seen to be a problem, but public transportation and its lack was constantly cited as a barrier to relocation. This factor is especially �important for parental visitation which is or�ered, in m�ny cases, by the court and felt to be of primary importance to family reunification. b. Other input cited the following issues: o there needs to be P.R./education in the suburbs before developnent of new residential settings can be accepted. o many of the children in Rule 5 and 8 are hot Ramsey County residents (75� average) . 4Jhat should the state and county 's policy be on encoura�in�ldiscoura�;ing these placements. This � issue is of real concern to many of our Rule 5 and Rule 8 facilities would go out of business without these out of county children. Connersely, many Ramsey County children (89 out of 125 children as of Narch 1 , 1985) are in out of county Rule 5 and 8 placements. . -34- ��9 o It is seen as difficult/impossible to meet either the spirit or the letter of the laws (both state and federal) that mandate ' placement of minora.ty children in facilities that ar•e "culturally, reacially and religiously sensitive" if new developrrient of these facilities occurs in areas removed fran where the majority of inembers of their community live. o All currently operating Rvle 5 and 8 facilities are doing so in compliance with state lice:�sin� laws and the zoning ordinances of St. P2u1. All have up ta date vari.Gnces frcm city zoning and the agreement of their neighbors to op�rate. o All ver,dors agreed that no new develepment should oceur in already overconcentrated areas with the possible exception of those specifically �esigned t� meet cultural�ly appropriaLe needs of children. o All persons felt existir;� children's facilities should be grandfathered in, but many recommended that zoning variances and special use permits not be automatically transferred from old owners of facilities to new owners. , -35- � ��9 C. Services to the Chemically Dependent � . Target Population The chemically dependent/drug abusing target population in Ramsey County is estimated to be appr•oximately 40,000 persons. This figure is arrived at by applying the percentage of affected population estimates of the National Institute of Alcohol �.buse and Alcoholism (NIA�) and the National Council on Alcoholism to the known population of Ramsey County. The PJational Institute of Alcohol Abuse and Alcflholism estimates that 6.6°,b of any given population in the United States suffers from chemical dependency. The National Council on Alcoholism estimates that 10°b of any given population abu,es or is dependent en alcohol. When these percenta�es are applied to the Rarr,sey County po�ulation, it would appear that 3�,�00 are cherically dependent and approximately 40,006 are either dependent or abusin� alcohol. Definitions of alcoholism (chemical depEndency) have been provided by the American htedical Association, the 4dorlcl Health Organization, the National Council on Alcoholism and other service orgac�izations. Although each may differ sli�;htly in perspective, they all agree on these major points. It is a disease. It is progressive. It is �hronic and, if not � treated, it is fatal. For planning purposes, the Ramsey County Htunan Services Department defines chemical dependency as "a disease which is progressive, chronic, pathological relationship of a person to alcohol or other drugs which significantly interferes with one or more major areas of a persons life." 1. A Description of Changes, Trer�ds, Develo�xnent Currently there are nine Rule 35 licensed residential facilities in Ramsey County. They can be divided into two groups, those that serve adolescents and those that serve adults. Serving adolescents� only, are: Number of Licensed �i.s�r�� ..._._s��_ o �Jew Conr�ecticns "S" 3 15 beds 176 Prospect B�ulevard t o New Connections "A" 13 15 beds �44 47est Lynnhurst Avenue o New Connections, Inc. 9 2b beds 73 Leech Street _36_ . C��-�� Serving adults and occasionally some adolescents are: N�snber of ' Licensed . Dj,�trict ,�3eds o Union City Mission 7 20 beds Sherburne House 550 Galtier o Dayton House 8 15 beds People Incorporated 565 Dayton Avenue o Fellowship Club 9 55 beds Hazelden Inc 680 Steward Avenue o Juel Fairbanks, Inc. 11 21 beds 806 Pdorth Albert . o Twin Town Center 13 50 beds 1706 University Avenue o Team House 17 36 beds Granville Inc. 54 West Exehange • These nine, Rule 35 residential facilities can be further divided into primary treatment programs, halflaay houses and extended residential treatment programs. New Connections Inc. and Twin Town Center are facilities under the classification of "primary tre�tment". � Dayton tiouse, Fellowship Club, Juel Fairbanks, and Team House are facilities under the classification ot' "halfway houses". Sherburne House, New Connections "A", New Connections "B" are facilities under the classification af "extended residential treatment programs". On an average, only about 30� of the Rule 35 beds availabile in Ramsey County are utilized/funded by our department. 7'he remaining beds are be.ing funded by thi.rd party� private pay or other counti.es. . Increased useage of' facillties located in Ramsey by other ocunties and in some cases, residents of other states be�an in 1981 with an aggressive marketing effort by these facilities in an attempt to keep their programs open despite our major fiscal cutbacks. 2. Urunet Need for Residential Facilities -37- //��i/�� C' ' The low util.ization of existing Rule 35 beds by Ramsey County is the resUlt of budget and funding restrictions rsther than a reflection of ' need/demards for services. Tncreasing thP d�mands for com,munity based residential care is the growing reliance on s�ort (ten days or less) inpatient prir:ary treatment progr�ns �nd the growing population of dual disabled (MI/CD and t�1R/CD) individuals. Development of additional or expanded community services within t.his service area are expected to be in smaller, specialized programs designed to meet short term needs for supported living progr�ms or to address s�ecific issues of dual disability. Proposed cr,anges in the fundin� of chEmi.cal dependency services being considered by the hiinnesota State Le�islature may also result in . additions to the number of non hospital based primary treatment beds available in the c�unty. These programs provide a less costly alterr,ative to hospit;al based services for the provision of prir�aary care. If programs are devElope�, th� county will require that these programs be located outside of already concentrated districts. 3. Constraints/Barriers The primary constraint/barrier exisLing in provision of C.D. services tend to be issues of func:ir.g anc� coordination. The majority of C.D. providers are reliant on :nul�iple sources of funding and have tended to be viewed as "marlcet-driven" syster�s. This tends to make these programs more insulaY.ed from the actions of any one coun�y or• funding source and more reliar�t o� larger changes such as changes in third p�rty reimbursement, restrictions on h;edicaid and GAAIC funding and chan�es in health couerage through HP`�s. 4. Methods Used Lo Revie�a Bed Redu�tion/Dispersal and Specific Suggestions A questionnaire was developed and sent to all Rule 35 faciliti�s (Appendix A) , auvisor}� cor��:ittee members, C.D. Planning Team members, selected residents of Rule 35 facilities and zr.t;erested others. A meetin� was scheduled with the Rule 35 facility administraLors as a group. A represent;ative of the �epartment's advisory conunittee w�;� present as wel]. as the hlinnesota Department of Hwnan Services. The meetin� was facilitated by the Ramsey County Human Services Department's C.D. planner and one of the department's contract managers. At this meetinE; the issue of "averconcentration of community residenti2l facilities" as well as this issue of the 1 ,320 foot rule was examine. The department's C.D. Planna.n� Team and the C.D. Advisary Subcorrxnittee twice discussed the zonin� law during the fall of 1984. The suggestions made by Rule 35 facility operators as well as the _38_ ��-��9 planning team and the advisory subcomr�ittee are: o Do n�t force facilities to relocate. ' o Initiate a selective mor��torium on the development of new Rule 35 facilities. o Devel�p an educational package for use in explainir�g the need for services and to attempt to achieve a higher degree of acceptance in the coc�rnunity. o Any future development of community resi.dential facilities take into consideration availability of public transporation, rehabilitation services, habilitation services, recreational services, social services, and other support services. o Facilities now located in planning districts that are over- cor,centrated should only be dispersed through a system of attrition. . -39- �'=�.��s� 9 D. Services to the h9enta11y .I11 Target Population ' Mental disorders are conceptualized in the Diagnostic and Statistical Manual, third edition (DST; III) as clinically significant behavioral or psycholo�ical syndranes or patterns that; occur in an individual and are typically associated with either a painful symptom (distress) or impairment in one or more of the irrportant areas of functionir,g (disability) . In add.ition, there is an inference that there is a behavioral, psychological or biolo�ical dysfunction and that the disturbance is not just in the relationship between the individual and society. Social deviance per se is not regarded as a men�al disorder. DSM III assu�rles that the boundaries bet�aeen different mental disorders and no mental disc�rders ar•e not sharp or distinct. 'fhe assumption is also present that individuals within diagnostic groupings can differ in significant ways from others with the same disorders. This suggests that treat��nent must be individualized to meet the person's needs. In light of these descriptions and presumptions abou� mental disorders, DSH1 III provides estimates of incid�nce within the general . population�. The estimates are based upar, the most current definitions and knowled�e of the d3sorders. These estimates can then be applied to the current population figures of Rams�y County to provide us with an idea of the scope of the task we are faced with to deal effectively with the individuals �a.ith these disorders.�'� The primary population tar�eted in this pldn is as follows: o Major depressive episo�es requiring h�spitalization FSTIMATE NUTtB�'R .p�.C�l � r�tSEY COUNTY Males 3� 5,160 Females 6� 10,320 o Bipolar disorder Males & Females 0.4-1 .2� 1 ,376-4,128 o Schizophrenia (Males & Females) 1� 3,�40 o Also of concern are: - those effectively disordered who are not hospitalized. These ran�e between 5-8� of males and 12-1'l� of females. - anxiety disorders, ph��bia, adjustment disorders and psychosexual disorders that effect up to 5p of the genera� population. - personality disorders that also effect up to 5n of the general population. -40- ��.�-��9 �Estimates rather than actual numbers are used. � � *�Based upon Ramsey County population estimated ( 1983) of 464,8q7 of which 3�4,024 (74�) are adults. . -41- �i---�� 1 . Description of Changes, Trends, Development The impact of deinstitutionalizatian has probably been most � dramatic and more widely felt in the provision of services to the mentally ill than in any other �arget population. Beginning with the closure of state hospital beds up until the present time, the cor�munity of professic�r�als has struggled to develop, fund and maintain a system of care and treatment that will best meet the needs of this population. In part these stru�gles have occurred because unlike the care syst��ms for oY,her tar�et populations, this community based service delivery system is expanding and emerging while still attempting to meet the needs of people already glaced or displaced into the community. �tajor efforts at both the state and county level have occurred in this process but major efforts and barriers remain. There are a number of major changes �oing on presently with the service delivery system for the mentally ill that may substantially impact on t�e long range designslstructures of residential programs. • Funding & Licensing At the present time residential care facilities serving five or mc�r�e individuals having mental illness are required ta be licensed under Rule 36 and licensure as a Rule 36 fa�iiity is a precondition for receipt of Hule 12 monies to support progr�ms and � services to residents. The state legislature has authori.zed and the Department of Human Services is presently preparing a Rule that will allow for the development of alternative levels of residential care to Rule 36. This rule however, is not expected to be available before February of 1986. In addition while authorizin� DHS to develop alternative residential pro�r�is they did not authorize al.ternative uses of the funds av�ilable. This issue will r,eed to be addr2ssed in an upcoming legislative session. We would anticipate that as changes take place in authorized funding and licensing that concurrent changes can be made in the residential care pro�ram. Demographic Changes In evaluatin� the age and ct�aracteristics of thi.s population t�ap • strjkirg trends are evident. The first is the number of individuals over the age of 65. As of' JUne 198U, individuals resi.dir,g in Rule 3b based pro�r�rns were 65 and older. In two facili�ies currently uncier consideration f�r licensure and one whi.ch has already been licensed, the 57 of the 6B residents are a�e 60 p1US. Tt�is population is of an age �roup that tends to have ^��_ �� / experienced frequent and lengthy hospitalizations, have been ill for many years. Tt�e department will need to develop progr�►ns� and services for this popealation to provide meaningful ar.tivities while ' recagnizin� their limitations. In contrast to the older, previously institutionalized population are the adults in their 20s and 30s wY�o are being referred to in the literature as the youn� chronics. While there continues to be disa�reement as to haw and to what extend programs for these young adults differs from the needs of those ten and 20 }�ears alder there is little question but that their characteristics are different in lar�;e part because of charges in patterns of hospitalization and drug use and their will�ngness to be involved in formal treatment pro�rams. Political, Legal & Social Changes Over the course of the last five to ten years there has been numerous changes which impact on �he shape and content of the services needs of this populaLion. The first and perhaps most positive change has been the growing awareness of both the political and social corrununi.ties of the needs of the mentally ill and their families and a decreasing of the stigma attache�l to the recognition of inental health needs. Unfortunately at the same time as we have been increasing our awareness of the nePds of the chronically mentally ill we have also witnessed a decrease in the willingness of third party insurers and government health programs to pay for care and treatrnent. In addition to the changes cited abave, other emerging trer.ds that have or will effect the service system ir�clude: o revisions i.n the commitment act resulting in feu��er invflluntary treatments and a greater ernphasis on individual choice o increased ability of consumers, advocates and prafessionals to develop a constituency capable of influencing the legi.slative process o continued, althou�h slow, developments of new technology in the treatment and control of the effects of inental illness. 2. Unmet need for Residential Eacilities We expect that over the next five years we wili continue to see�an increase in demand for residenti�l services for individuals who are mentally ill but ti�ith a concurrent i.p�crease in demand for an array of residential prc��rams tnat is capable of addressin�; the multiple nec:ds of cl.ients both for supervision �nd for treatment. Current UtilizaGion and AnticiF�t,ed Demand -43- C��-�� The following material outlines by volume our current and � anticipated den�<�nds for residential care fcr the mentally ill. � While the references are to Rule 36 beds thi.s reference should be taken only as an indication that it is the only cperating and funded rule available for services to this population. As the material whicti follows on service needs indicates wtzile there is an increase in demand fer services th�re is also a need to expand the allowable/funded programs to morF aciequately address these needs. In February, 1985, there were u26 Ramsey Cour;ty residents in Ramsey County Rule �6 beds. To project resi�ential need for Ramsey County residents we be�in with the �126 figure as a base and adjust according to expected chan�e in Ramsey County population,the number of new individuals entering the system, the number of residents currently placed out of county �n�i a percent allowed for empty beds. Thc Ramsey County Cornrr�unity Support Froject has been providing outreach services to the hcmeless who are mentally ill. Based on their experienc� they arA projectir�g that there are 30 ir.dividuals currently hon�eless who will be entering the residential services in the future. The Ramsey County Human Services Department adult intake departrrent experienced a 24� increase in 198U -of clients who are m�ntally ill and in need of placement. The increasP in the number of ht.I.adults referred to ' our intake department t�as been clambing steadily over the last few years and is not expected to decrease in the foreseeable future. In the Ninnesota Dep�rtment of Hurnan Services' , 198� report to the legislature regardir.g Rule 36, 12 and 14 , it is rr�ported that in addition to the 2,200 h1.I. residents in Rule 36 type facilities in Minnesota, approxirrately �,000 - 5,000 P�iinnesotans have rnental health needs appropriate for placement in � Hule 36 licensed facility, semi-indeper,det�t living ar�r�ngerr�ents or a supportive living residence. The Cc��nmunity Support Project (CSP) Housing Survey showed that there were 60 individuals on waitino lists for Rule 3b facilit;ies. Usin�e the data currently available, the projected numbers of needing residential services: �426 Ramsey client;s in Ramsey County +85 20H increase projected by Human Services Department Intake 511 +30 Increased de�r,and from haneless population 5u1 +6� 4Jaiting I.ists �� 601 Clients placed out of county In February 1q85, there were 180 out of county residents placed in Ramsey County. In order to determine anticipated chan�es in their placc�nenLs in our county a survey was sent to the five primary users, Dakota, Washington, Anaka, t9ennepin and atearns Counties -�14- ��.��/6�9 (Attachment 7) . Survey Respanses were received in writing from 4lashin�,ton, Dakota and Hennepin countiea. Anoka County responded by phone. Na resE�nse was received from Stearns Cotanty. The � follawing material su�u�iarizes their responses. (tlttachment 8) . a. Washirgton County anticipates that they will utilize 10 less beds in Ramsey County Rule 36 facil.ities as a result of new progr�un development. b. Dakota County reparted that they do not expect any change in their utilization of Ramsey County Rule 36 beds. c. Hennepin County is projecting very little change in their utililzation of Ramsey County Rule 36 beds. They reporte8 that Breckenridge, a 16 bed facility for chronically mentally ill clients over the age of 35, might el�entually bcome an alternative placement for clients who may have previous�y been referred to facilities such as Central hianor or Family Style • Homes. d. Survey response was not received from Stearns County. Stearns County's new t�en bed facility had, however, already been opened, and they still had ni.ne residents in Ramsey Countcy. Therefore, the projected demand for out of county placements in � Ramsey County is: 180 Qut of county residents in fiamsey Count,y .1Q �.ess Wa�hin�ton County �lecrease in demand 170 � Less flennepin County possible decrease in demand 154 Total projected out of county demand 601 Total projer,ted demand for Ramsey County residents 1� Add t�tal prajected demand for out of county residents 755 Total projected demand Changing Residential Needs a. The needs assessment completed by the Eluma� Services Department for the 1985-86 CSSA Plan showed that the Lop seven neecis were: o hfI-CD o Crisis Intervention �. o Special Management o Semi Independent Living o Three Quar°Y,er 4�)ay House _�5_ 1��= ��9 o Safe House . • o Crisis Hc�mes b. Currently, the Human Services Department direct social service staff recommends that the followin� residential needs are priorities: o More SILS type programs, greater emphasis on supervised/ independent livi.n� services. o Smaller homes of four to six (maximum eight to ten) . o h;ore Tasks Unlimited Homes, provides more relevant programming truly e�nphasizing normalization and mainstreaming. o Expand safe house madel both as a short term crisis facility to prevent hospitalizations and longer terrr: assessment/ stabilizing. o Continue Rule 36 licensure for present Rule 36 facilities. 'rJhen SLR rule is written, apply that rule to unlicensed and new facilities. c. The housing task force, created by the Community Support Project, outlined the following res�dential needs: o Indep�ndent and semi independent living situations o Placements far clier.ts with multiple problems o Affordable housing o Emergency housing with su�port staff o Inereased number of adult foster r�omes o Centralized and computerized inform�tian. d. Residential needs identified by various consumers and groviders during the past two months include the following: o Pleed for increased crisis services. �. o Need for expanded pr'o�r��mmin�, increase availability of activities, recre�tion, socialization, ILS training, sexuality �roups� etc. o Case mana�ement� this is identified frequently and continuausly and is seen as a hi�h priori.ty need and rel�3tes to residential -46- C��=�^-�� service neec�s. o Need to de-emph�size the "movin� an" trend. Clients are being � set up to "fail" because of this emphasis on clients moving on from Rule 3�. o ��eed far day and residential services to work with consumers with liehavior problems. o Need for adequate financial resources for clients. , o Need for a system to work with cl�ents leaving the hospital and �oin� ir,to the comrnunity before a crisis occurs. o f�eed for a universal level of care. Cor;imon themes in the asses�ment o: residential. needs are the need for a comprehensive case rnanager;ent system, the need for more independent ancl semi inde�endent living opportunities, partic�alarly that c�n be pravided in smaller, more horne like, community based sett.ings and provided on an individual needs basis. There is also a need to provide crisis services and a need for residenti.al placements for indivi�uals with behavior problems and che;nical dependency. t�et�hod Used to Obtain Input Regarding Overconcentration & Di�persal • In October of 193�1 current residen�ial service providerst advocates and professi.onals were provided with a copy of the law and a ssurvey clesigned to elicit their inUuL into the development of a plan for the dispersUl of residential facilties in o��erconcentrated districts. Appendix A provides a li.st of the people who received this material. In addition to the written in;�ut providers were invited to aLtend a meeting on October 26, i9�4. As part of the development of the plan for residential services requestcd by tr,e Department of Eluman Services we were again offered the opport.unity to meet with providcrs and advocates in early April to discuss a�;ain their ideas about needed changes in the sysLem but how to m�:et these needs in a manner consistent with Chapter 617. A li�t of tt�e individauls attending that meeting are included as Attachment 9. ; � 3. Constraints/Barriers Constraints in�rolued in shiftin� the kinds of residential services availability are primarilly financial and lc��al. New legislation would be needed to allow money to be attached to people ratt�er tPian attached to pro�r��rns. The counLy h�s not committed money to -47- C�=�S-��9 assist in any dtspersal of facilitfes' efforts and there has been no state le�islative actions to provide for• rnoney to assist in relocation or dis�ersal. � 4. Specific Input Received Regarding Zoning Plan, Dispersal, Overconcentration o Complete more research on these issues. o Request that May 1st deadline be extended. o Stop issuing new licenses. o If any facility closes in overcrowded area, do not replace beds in that area. o Determine transportation costs. o Consult with clients about where they want to be. o Promo�.e supplEmentary services in the suburbs o Examine issue of how the half percent population figure came about -- perhaps lobby to get that changed in view of the fac� � that there may be more than a half percent of the total population who needs so�e kind of residential placement. o Form a ca�nmittee of facilities (especialJ.y large facili�ies) , state and county representatives to start planning about dispersal, zor.ing, relocating, etc. o Maybe the committee mentioned �bove should be appointed by the the county board and have board representation including tr.e Metro Council and the Health I)epartment. o Offer pro�ram assistance to relocate. o Recomrnend the county have a policy favoring placement in facilities with a lic^nsed bec� size of (25?, 1;?) or smaller, that by 199� all placement/payrnents by the Human Services Department will be Lo facilities wi.th a licensed bed size of (45?, 50?) or �maller, anci that no certificate of need app�ication for a pro�r�rn exceeding a licnesed �ed size of (45?, 50?) will be approved. o Inform pro�r�rns now that reductions in coneentra'ted districts` must take place, stop additicnal placements to programs in overconcentrated districts, and develop a plan to relocate programs or clients f'rc�m these overconcentra�ed districts. o Do not rr�ake reductions in placements of pro�rams that are 15 -z�8- �� s�� beds or smaller so progr�uns are not penalized by "econany of scale". - • o For some very large programs, operation on a much reduced scale will be impossible (run a progrum licensed for 100 with only 15 beds full?) . These pragrams, if they fill a need of the county, should be assisted in relocatin� in non concentrated districts with the stipulation that a new program may not exceed a certain size (35?, �5?) . o Needed small programs wi.th an overconcentrated district could be maintained at a sligt�t reduction in bed size, or assisted in relocation. . _t�c�_ ��-��-��9 N. COi�'�fUNITY INYUT � In adciiticn ta the input sought From professianals and providers of services to the prirriary target populations, we have also solicited input from community representatives, elected officials and other governrriental staff regarding the development of new programs ancl the dispersal of existing programs. This prccess included surveys, meeti.nas and s:nall group discussion. Tt�e followin� material outlines hoth the questions posed to these individuals as well as their responses. These individuals contributed greatly to this process. In addition to raising specific cor�cerns and problems they also through their willingn�ss to talk with us helped to crystalize so�ne issues that have not .in the past been addressed and helped to suggest mechanisms for improvin�; and m�intaining cor��munications. Information/input was sought from the following individuals and groups: o The mayors, city rnanagers, chief clerks, anc chairpersons of the Citizens Planning Comani.ssions for the city of St. P�ul and all other m�.anicipalities in the County of Ramsey. (See Apperdix A) . o The community organizers for the planni.n� districts for the city of St. Paul (See Appendix A) . o A citizens group in an overcor,centrated district within the city of St. Paul ; o Representatives of the Planning Department of the city St. Paul. o All involved community based residential facility providers. Co Non residential service providers and advocacy groups. To each group we have possed the follow.ing questions: o How would you suggest that Rarnsey County promoLe and ir,�plement the dispersal of residents in existing facilities located in highly concen�r�ted area? o How would you sug�est that R�;r�sey County pranote the establishmer�t af facilities in areas which are not highly concentrated? o What do you Lhink the impact would be upon residents who may be dispersed ta ito areas of low facility concentration, i.e. , suburban areas? � o What do you think the impact would be upan faci].ities �nd service organizations � , that may be dispeersed to ar•eas of low facility concentratian, i.e. suburbar� areas7 o In general , how would you descri.be the acceptanc:e in your community of the need for or the devel.opment of hones to provide �^rvices to �ndividuals with handicapping conditions? Are there vari.ables, such as s�ze of facili�ty or type of handicappin�, conditions that you bel.ieve affect c�mmuni�y acceptance of these progr�ms? -50- ��s -/5�q o hlany communities presently have sm�ller (si.x or fewer people) homes that are not covered by th�s specific acldition to the zonin� law. In �eneral, how would you describe the nei�hborhood or cc�rununity�s acceptance of these programs once they have been aperatin�; for a peried of time? • 0 1•lhat approach(s) in providing community a4rareness prc�grams and public education do you believe ��ould be most valu�ble for the county to develop to a�dress communiLy concer•ns that my exist regardir�g the location of residential. programs in your city? 0 61hat do ycu see as the primary barriers ta the development of residential � progr�rr:s within your community? (i.e. , transportation, cor�munity concerns, ete.) . Please list them in orcier o�' importance to ycur community. o Given these barriers, what changes wculd you see as being needed either in the way services are �rovided or in our approach Lo developing services that would � assist u, in overcor�ing these barriers? � o What additional issues/concerns do yau believe neeci to be taken into consideration in the ong�ing plannir,g for residential services? ; o Would you be willing/able to parti.cipate on a time limited basis, with other ; cities and the county on a task force to review and develop specific respc>nses ; and approaches to the dev�lopment of corununity based care? .. f0 Woc�ld you be willing, as a vendor, to meet with other vendors and � plannin�/social service staff to review residential needs and ways to meet � them, on a county wide basis? The input received from cor,:munity providers and advocacy gr•oups is included in Secticn II of this plan. The combined input from the city of St. Paul and the municipalities follows. 'The city of St. Paul has also rec�ntly undertaken a study of all of its com��unity resi.dential f3cilities with the intent of reviewing existin� policies and practices regardirg city licensure and establishin�; policies for the future. We have had an opportUnity to �hare with 'che staff preparin� this plan aur knowled�e of existing services and the antici�:ated chan��s in trends and demand and have a_ked for an opportunity to continuc� to be involved in this project as part of the ongoing devleopment and ir�pler�entation of this plan. I I � �, � -51- ��s�i.�� COMMUNITY R6IDENTIAL SERVICES Q UESTIONNAIRE , � 1. IN GENERAL, HC1W WOULD YOU DESCRIBE THE kCCEPTANCE IN YOUR COMMUNITY OF THE NEED FOR OR THE DEVE7.OPMENT OE HOMES TO PROVIDE SERVICES TO INDIVIDUALS WITH HANDICkPPING CONDITIONS? ARE THERE VARIABL�, SUCH AS SIZE OF FACILILTY OR TYPE OF HANDICAPPING CONDITIOr]S THAT YOU BELIEVE EFFEGT � COMMUNITY ACCEPTANCE OF THESE PROGRAMS? o Our community has no objection to the construction of such facilties within our city. We think they provide a valuable service to the city. � We currently have no such facilities. , o Very negative o This issue has not heen specifically aired during my public involvement , in Roseville. However, the Planning Commission does balance community/metro concerns with neighborhood concerns. We recently permitted a metropolitan hazardous waste facility, for example. Without � � question, the societal issues are weighed against impacts or� su�rounding properties. Scale, activity levels and neighor perceptions are important I� considerations for specific proposals. � o Very poor prior to the establishment of the facility. Very good after the facility is in operation. Size is critical. Education of the neighborhood as to what expectations they should have as to what impact the fac3l:ity will be. o Based on past experience, they would not be overwhelmin�ly accepted. If units were small enough, acceptance would be gradual. North St. Paul has not had a great deal of experience in this area. � o An apprehension at group homes in general. Group homes are not seen as � compatible with single family neighborhoods. The larger the facillity, the less the acceptance. Mental handicaps are less well received than � physical. I ; o The acceptance of New Brighton neighborhoods for group homes is unknown. ' Those factors which would affect community acceptance of handicpped facilities are as follows: �- 1. Which neighborhood the facility was to be located; 2. What type of group home was being considered, i.e. , physically handicapped, mentally handicapped� halfl�ray house, etc; 3• Number of proposed residents; 4. Condition of existing home; and -52- (��'S r isa� 5. Proposed security for the facility. o Negative. Both size and type affect neighborhoal acceptance. We had � one such proposal for a small facility in a residential area and there was substantial opposition. o In general, I believe the city has been quite accepting of individuals with clearly handicapping conditions by which I mean physical handi- ' ' caps and mental retardation. People who abuse various form of , chemicals are less well accepted. The size of the group has a high impact as does the length of time the individuals are in reserve in a facility. Long term residents are better accepted. A major factor is also the degree to which the facility is maintained. The m�re a ' building is maintained, the more a building matches the surrounding ' is the more its residents and staff will be accepted. ( 2. MANY COMt�tUNITIES PRES ENTLY HAVE SMALLER (six or fewer people) HOMES THAT ARE NOT COVERED BY THIS SPECIFIC ADDITION TO TE;E ZONING LAW. I�1 GENERAL, i HOW 410ULD YOU DESCRIBE THE NEIGHBORHOOD OR COMMUNITY'S ACCEPTANCE OE' THESE , PROGRAMS QNCE THEY HAVE BEEN OPERATING FOR A PERIOD OF TIME? � o Our city is opposed to the mandatory allowance of such hanes in residential areas. 0ur feelir�g is that they are appropriate �nd permissible in residential areas where the neighborhood has no I � ob�ection. We have had no experience with any such homes operating in our city. We only recently lost a court battle in which we were required � to allow the construction of such a home. f o Continuing negatively. � o My sense with most impact issues, the perceived impact of changs is much more dramatic than change itself. Acceptance level seems to match experience. o Very good. � o Gradual acceptance - none presently in existence. I o I am not aware of any such homes in the city. If th�re are, we have had � no complaints. f � o Unknown. � o Do not have sufficient information to answer this question, not having I been exposed in depth to any operating facilities. �- , o There are more readily accept�d but the number seven seems to be an , arbitrary one. I think all sizes should be included in your plan. 3. WHAT APPRQACH(S) IN PROVIDING COMMUNITY AWAREhESS PROGRAMS AND P�BLIC EDUCATION DO YOU BELIEVE 4JOULD BE h10ST VALUI�SLE FOR THE COUNTY TO DEVELOP -53- ��,�_ �5-09 TO ANY COMMUNITY CONCERNS THAT MAY EXIST REGARDING THE LOCATION OF RESIDENTIAL �PROGRAMS IN YOUR CITY? ' o I have no strong feelings or expertise in this area. • o There are none. o General positioning information compaigns help build a revised � perspective over time. However, lack and serious awareness programs have , little impact on protesters. They are most appropriate to deeision-makers who with some facts may be able to take an appropriate, albeit, unpopular stand. � o A general community awareness prior to a specific site selection process would be most helpful. After a site is selected an awareness program is � not useful. � ' o Articles in corr�nunity newsletter. Neighborhood informational meetings. � Realistically describing overall programs. Eliminate surprises. , o Allow neighbors around a prcposed site to view and meet residents of a � similar facility already in operation. � ' o A county wide education progr�n would be required to explain the need for � group hcme facilities, explain how the county proposes to meet the needs ` for group hames and explain the pros and cons of such a program. Such � education program would need to provide public informational meetings on � the city wide and neighborhood basis. ` o I am really not sure just how to go about it. Certainly, education and � public awareness of the need must be developed but I doubt that people will digest any information until it appears it will have an effect on their lives or property. To target a specific area where it is possible for a facility to be established may be the best approach and least costly. o In order to attract people's attention now, one has to canvas ` neighborhoods and talk face to face with concerned residents. Mass media Ior meetings will not reach enough people. ( 4. WHAT DO YOU SEE AS THE PRIhiARY BARRIERS TO THE DEVELOPMENT OF RFSIDENTIAL I PROGRAMS WITHIN YOUR C01�1t�1U(�ITY? (i.e. , TRANSPORTATION, AVAILABILITY OF i PHYSICAL PLANTS, COMh!UNITY COPJCERNS, ETC.) . PLEASE LIST THEhI IN ORDER OF IMPORTANCE OF YOUR COMMUNITY. I �- • o Canmunity concerns - fear of neighbors that such group homes will devalue their homes. , o Corrununity concerns, others are secondary although present. o It seems to me that a location criteria base would set this perspective. _5�_ ��S-iS�% Absent that, I would �uess: Availability of appropriate building types� limit of new development areas, walking scale proximity. � o Fear of the unknown. Concern for property values. Concern what impact � there will be on neighborhood and expecially on children who will see something of the less pleasant sides of life. o Neighborhood resistance. (Concern because of lack of progradn knowledge.) � ' (Concern about declining property values.) . Availability of physical plant. o Neighborhood acceptance. o Community concerns. Availability of physical plants. Transportation. 0 1. Community concern. 2. Availability of physical plants. 3. Location and size. 4. • Accessibility for providing services such as transportation, recreation, medical. o A logic for residential programs, I do not believe the general public understand a rapport the fundamental concept. Just how are people made more whole by livin� in a residential district? A residential program can � � only be as good as its staff? � The economics of facilities demand a large population this limits the � areas in which they can be located and would seem to also work against , the concept of dispersement. I I 5. GNEN THESE BARRIERS, WHAT CHAAIGFS WUULD YOU SEE AS BEING NEEDED EITHER IN THE WAY SERVICES ARE PROVIDED OR IN OUR APPROACH TO DEVII.OPING SERVICES � THAT WOULD ASSIST US IN OVERCOPdIR'G THESE BARRIERS? o No definite opinion. � o There are none. , o Most are result of suburban fabric. Clearly opportunity exists to enlist � community in identifying/accepting need, establishing location/program criteria, and identifying "search" areas of potential leading to specific sites. o Small facilities that are supported by state law. � o Educating the public. o See �3. o Public education, especially on a neighborhood basis, would be the best way to overcome community concern for such facilities. -55- �'�-�'r/5�-� o Since I am not too familiar with the services and approach to developing service now existing, I would not presune to suggest necessary changes. � o reservation of the compus concept. Perhaps a new set of larger facilities in the suburban districts would be a superior condition for the handicapped population. It seems that �ust because the "state hospital" concept has been abandoned, we have opted for small scale and very expensive programs. The facilities for several handicapped operated by People Incorporated would be a good model. 6. WHAT ADDITIONAL ISSUES/CONCERNS DO YOU BELIEVE NEED TO BE TAKEN INTO CONSIDERATION IN THE ONGOING PLANNING FOR RESIDENTIAL SERVICES? o We think it is unfair to require cities whicn are smaller to allow group homes into their residential areas when neither the state nor county provide the necessary inspection services for such homes. Small cities like ours do not have the staff or funding to provide inspection or licensing services for such group homes. o People want a quiet life. They have been, and feel they will be disrupted by "homes". o This all preswnes a basic�background and understanding. Probably most significant is a neighbor information and security net. Open house types of info sessions and some security program such as open line information spread the rLUr►or. o A demonstration that facilities are not just placed in the less affluent areas of the community. � o Does the new legislation really address a problem? � o Make sure residential homes are canpatible in appearance and operation to ' surrounding neighborhoods. o Local zoning ordinance will need to be evaluated to determine how such uses could be allowed in s�ecif'ied zoning districts and what types of control can be retained throu�h the local ordinances. o I think scme assessr�ent should he ncade in tems of the cost of smaller facilities. Are there uuplicatior,s of services and personnel? Are the smaller facilities accomplishing what was hoped for? Should we cansicler a new facility that coulc contain all the corr�rion needs (i.e. , medical, recreation, therapy, etc.) and yet not be built in an institutior� fashion? o The difference between "half�ay houses" for chemically dependent and criminal offenders as distinct from mentally and/or physically handicapped must be made clear. A short term care facility can not be classed with a "fosten c�xne". The prablem of corrununity acceptance are -56_ ��i5a9 greatly compounded by the present blurred clarification systems. 7. WOULD YOU BE WILLING/ABLE TO PARTICIPATE �N A TIME LIMITED BASIS, WITH � OTHER CITIES A�iD THE COUNTY ON A TASK FORCE, TO REVIEW A[JD DEVELOP SPECIF�C RESPONS'� AND APPROACHF.S TO THE DEVELOPMENT OE' COMMUNITY BASED � CAR E? o No. o Can't. o Depends on structure, time and change. Would certainly consider. o Yes, time permitting. o Yes. o No, hawever someone from one of our volunteer commissions may be interested. o Yes, we would consider participating. o Yes. - o Yes. � . � I � � -57- . �r�`s-��'� Ongoing Community Involvement ' As has been indicated earlier, one of the clearest outcomes of this � process has been the identification of the need to develop and maintair� open lines of communication between providers, the cities and the county regarding the development of community based residential programs. In order to accomplish this, the county, as identified in the work plan, intends to establish a number of inechanisms that will allow for ongoing input and feedback. These mechanisms will include: 1. establishing, with the assistance of the city of St. Paul, a process for: o insuring ongoing corr�nunication with the community organizers to provide information regarding program development. o establishing a mechanism for joint rev�ew and input regarding all new facility develo�nent covered under Chapter 617 regardless of its location. 2. establishment of an ongoing committee made up of repre�entatives of � the cities/municipalities, providers, and advocates to work with the department regarding the development and dispersal of residential care facilities. 3• establishing a process, including the implementation of an ongoing committee that will allow cities a vehicle on an ongoing basis for receiving information and sharing concerns regarding the development ' of community based programs. �_ -58- n�-�.��s�9 V. BARRIERS & CONSTRAINTS � As the meetings and input with public officials and staff, ci�izens' groups, vendors and advocacy representatives prpgressed, the topic of barriers and constraints to implementation of Chapter 677 became a significant topic of conversation. Although the specific barriers to dispersal are identified within the sections an each target population, there are some common themes that to have become apparent. Corr�nents have been made repeatedly, especially by aitizens' groups and the municipalities about the limitations of the law. It has been noted that only a small portion of the total types of community based facilities come under the jurisdiction of Chapter 617 and therefore the planning authority of county hurnan services department. Communities argue that this limit to the law does not give an accurate picture af the amount of concentration in many areas of the city. Many groups have noted the funding implications in dispersal of the facilities covered by the act. County officials and staff are concerned about how the extra costs could be covered in a time of dwindling revenues and resources for extra dollars. Providers, who are familiar with the funding constraints in Ramsey . County, believe that state financial support is necessary to make dispersal a reality. The act, however, has no funding for dispersal attached to it. Providers repeatedly stressed the need for financial assistance and higher per diems if they move from current facilities to newer/smaller/suburban locations. .Advocacy groups and social service professionals have told us that they believe • that the concentration numbers (1/2 of one percent) in the act are unrealistically low. These groups argue that 10-20� of any communities' population can be in need of residential services at any one time. Therefore the law's numbers do not acct�rately reflect community need. These same people also have wondered abaut the civil rights issues implied in regulating the places where people who need community based residential facilities live. This issue is also of concern to us and we plan to monitor the legal and Supreme Court opiriions in this area as they develop. Although Ramsey County has some ability to control where persans shall be placed for whan we pay, we have no ability to control the rights of legally licensed/operating vendors to secure residents who are private pay clients or from other counties. It has been our experience, that a substantial number of facility beds located in Ramsey County are not occupied by residents of this county and/or are not paid for by public monies. In children's programs, at any one time, approximately 70% of the residents are from other counties. In programs for the chemically d�pendent, approximately one third of the eare of the residents are paid for by public monies, one third are private pay clients and one third are • from other counties or states. In the facilities that care for the mentally ill, fully, one third of the residents are not fror� Ramsey Caunty. Therefore, if new facilities are created in unconcentrated areas, there is no guarantee that existing legally operatin� facilitfes would decrease in size. -59- . ��'S"=i,�9 VI. GFNERAL RECOF1MENDATIONS : . 1. There should be no involuntary relocation of community based � residential facilities which are operatin� legally. 2. That Ramsey County Humam Services should work with providers located in overconcentrated areas and who are willing to consider relocation or reduction to identify and seek solutions to obstacles. 3. The Ramsey County Human Services Department should facilitate efforts to continually involve providers and municipalities in discussions regarding the provision of community based care. 4. Ramsey County should develap a process for ongoing monitoring and modification of services to insure that to the extent allowable, programs are consistent with client need. 5. Ramsey County should work with providers and municipalities to facilitate the development of new residential programs and necessary supportive services. 6. Al1 new community -based residential facilities should give priority to locations outside of concentrated districts within the cities of St. Paul and Shoreview. The only exceptions should be programs with a clear and demonstrated need to be located near a particular ethnic/cultural group or specialized support resource. 7. Ramsey County should collect data an the use of community based . residential facilities by aut of county and out of state clients. 8. Ramsey County should bill for the full cost of residential and support services used by out of county and out of state clients. 9. All community based residential facilities should be required to have advisory committees, including community representatives. 10. Ramsey County should examine the feasibility of smaller residential pra�rams, with aptions such as staff sharing to increase cost effectiveness. Where possible, smaller programs . should be developed perhaps on a pilot basis. � -60- �� VII. COUNTY WORK PLAN � In response to the input received from all participants in this process and the data available regarding trends in residential care, the county has developed the follcwing initial work plan for addressing ongoing issues in the development and dispersal of residential care programs. During the next 12 - 18 months, the staff of the Human Services ' Department will continue its evaluation of the residential care system and make ongoing modifications to the plan. 1. Relocation of Existing Facilities in Overconcentrated Areas: a. The county shall continue its efforts to develop by January 1986 and implement by January 1991 , the plan for reduction of large M.R. facilities resulting (see Seetion III A) in the elimination of overconcentration in three planning districts. 2. Implementation of the anticipated SLR Rule As the SLR Rule begins to develop and become differentiated from or.her categories of licensure, the department will develop: a. A profile of the unique characteristics/needs of client groups � needing which types (SLR, Cat. II� Cat. I, Semi independent living) programs. Target date: August 15, 1985 b. Develop an assessment tool consistent with the level of functioning . scale that can be used to access all clients currently living in � residential facilities. Target date: October 1 , 1985. When the SLR Rule is implemented (DHS target date: February 1 , 1986) the following steps will be taken by the department: c. Within 60 days of availability of the SLR Rule, the department will evaluate clients in the following facilities to determine their appropriateness and impact on the client of placement in and SLR using assessment tool developed in b. o Amy Johnson o Quinlin o Pineview o Oakland d. The department will initiate a meeting upon availability of the� Rule with DHS to determine the most appropriate methods for: o modifying existing beds and negotiating any necessary transitions o placement planning for non Ramsey County, SLR appropriate clients. -61- . ��',5"/Sa9 3. Bed Reduction/Bed Transfer - M.I. Facilities � a. By September, 1985, the department will initiate with DHS, a selected metro-county and a selected provider, an evaluation of the feasibility of transferring a number of Rule 36, Cat. II to facilitate placement of clients in their hane county. ' b. By October 1 , 1985, the department will establish policies and procedures for reviewing and making recommendations for the use/ redistribution of beds in the event that an existing facility is sold. • c. The department will develop with Family Style Homes, Inc. by June of 1986 a specific plan for the phase out/dispersal and no later than October 1 , 1988 programs located at 3$3 Colborne, 397 Colborne and 368 Duke in accordance with St. Paul City Council Resolution 84-1121 . 4. Long Range - M.I. Facilities � a. The department will initiate by October 1, 1985, a task force made up of citizen representatives, county staff, providers and advocacy groups to study and made recommendaticns regarding a plan for long � range and ongoing modification of the current residential care system for adult mentally ill. The anticipated date for the report of the task force shall be determined by the task force but shall be set at such a time as to allow for appropriate review prior to the 19�? legislative session. � b. By January, 1986, the department will prepare specific work plans for assessing and making recommendations regarding the followinA issues: � o provision of and barriers to crisis intervention services. o standardized intake and discharge policies o alternative for implementing a more comprehensive case management system o feasibility of developing a client tracking system. 5. Community Involvement In Program Development � a. The county wili implement by July, 1985, a committee made up of representatives of teh cities/municipalities, providers and advocates to act in an advisory capacity to the department � regarding the develapment and dispersal of residenti�l care facilities. This coaunittee shall prcvide the county with assistance in developing: o a work plan to pr•ovide education, resources and information that would increase acceptanee of ccrrununiLy residential facilities. -�62- �� o a mechanism to insure th2t the development and licensing of community residential facilities are coordinated between the � cities and the county. 0 ongoing modification in this dispersal plan as conditions change. � b. The county will seek to develop with the city of St. Paul by August 31 , 1985, a method for insuring at a minim�an: o �oint review and in�ut regarding all new facility development covered under Chapter 617 regardless of their location. 0 ongoing communication between the Hunan Services Department and the Planning Districts regarding proposed development and changes in the service delivery system. o•a process for reviewing "special condition use permits" for facilities being sold. 6. General . a. The Human Services Department shall initiate by August of 1985 a meeting with the Depart,rnent of H�an Services and cther metro counties to discuss "state wide" facilities and their impact on overconcentration in the metro area. b. The Human Services Department shall investigate and make a recommendation to the Ramsey County Board of Commissioners by September of 1986 regarding legislation to fund reloc:ation and dispersal costs for existing M.I. facilities. c. The Hwnan Services Department shall develop by September 198b for review by the Ramsey County Board of Ccxnmissioners, legislative� proposals that would provide increased flexibility both in Rule and funding, the provision of re�idential services to the mentally iii. d. The Human Services Department shall request the assistance as needed and on an ongoing �asis, of the County �ttorney's Office to insure that this plan is and remains consistent with laws and court decision relative to the location of residential pro�rams. �. -63- ��Js�9 BIBLIOGftAPHY • oCor►munity Based �esident?al Facilities In Minne��lis Report of the City Planning Commission Committee on Group Homes, htinneapolis Planning Department, December, 1980. � o"Comprehensive Social Services Plan", 1985-86, Ramsey County Canmunity Ht,unan Services Department. o"Not In hty Neighborhood..."�, A proposal for alternative siting standards by Anne R. Carroll, 1981 . o�tennepin County Plan R�gardin� Concentration c�f Com�r►unity B�,sed ,��idential Facilities, by Hennepin County Community Human Services Department, 198u. � -64- �' �� , � . � �. i ��y , {�a ' 4y . G��-/�� c��y c�� s�int paul -- ~� �t � ��r�ning co�mossion resolution _ � � �i�� num�ier � :� �: 85-59 � ,r rn ��'�� July 26, 1985 � �� ,�: _ > �;° �� WFiERENS, the St. Paul Pl a ni ng Commi ssi on i s sensi ti ve to the human ri ghts _ ��..��.d:'. of all persons, and parti ularly sensitive to the need for provision of :' .�.,�r, adequate human services td protect the rights and meet the needs of our ..� �- - society's less fortunate members; and ,;:} .,.;� ,.��;,;; _ � ��,,, •�:�:- ��: � � �.� WNEREAS, the St. Paul Plarining Commission is equally sensitive to the needs �� of St, Paul ' s residents f�r personal safety, security, and the �* F ` �`��; . ,��,�� ; � prot�ction af praperty; and �:r� � .�=�.�� 1, . �� -;;� ,, l�1HEREAS, the St. Paul Pla ning Commission recognizes differences between y ,� .�.�� concerns expressed by aff cted neighborhood residents about facilities � i = " � licensed by the State Dep rtment of Human Services and those facilities �� licensec! by the State Dep rtment of Corrections• an� '""`�'�' � �.�`'-�.��r °,�.�� WNERE�IS, the St. Paul Pla ning Commission upon its review of the document " �'�' ' '�� ' '�.'� ' entitled RAP��SEY COUNTY PL N - OVER CONCENTRATION AND DISPERSAL OF - RESI�ENTIAL 7RE�TP�ENT PRO RAMS finds that implementation of this plan will ��° lead t:oward a better bala ce between the needs of those in our society requiring supportive huma services and the concerns of thQ City's - neighborhood residents fo the protection of life and property, but does not adds��ss these same cohcerns with respect to the proaision of correcti onal faci 1 i ti es ti,�i th�i n the coinmunity; �� NOW, THEREFORE, BE IT RESIOLVED, that the St. Paul Planning Commission �-� recammends that the Mayor+ and City Council urge adoption and implementation "` of this pl�n by the Rams�y County Board of Commissioners as a necessary � ` iirsf step toward the resjolution of c�mmunity problems generated by '� overconcentration of resi'dential treatment programs in certain areas of the City of St. Paul , recoynizing that continued communication and cooperation ` `'` hetween City, County, an State agencies involved in tMe determination of - �" '��'£4 ne�d, reyulati�n, and fu ding of these prorams �is vital to achieve a balance of human rights �or all citizens of our City; and BE IT FURThER RESOLVtU, �hat the St. Paul Planninc� Commission recommends that the P4ayor anci City �ouncil encourage the Ranisey County Board of Cor�mis�ioners to enyage �n a similar planning effort for community facilities providing cor�ectional programs. � �� if..� P a n I 1 . , -. � w �� / __..�. �� ' Unanimous Voice ote � � ��p�� i _ -