Behavioral Health Facilities Code Update

What is a Behavioral Health Facility?

Behavioral Health Facilities provide treatment services for people with mental health and substance use disorders. These facilities are diverse in nature to meet the variety of community behavioral health needs. They can include outpatient care, inpatient care, and residential treatment.

Why is Kent Studying Behavioral Health Facilities?

Washington state is pursuing updates to modernize the state’s mental health system. Best practices for behavioral health treatment have evolved significantly and now prioritize smaller community-based facilities. The goal is to transition patients out of large state-run hospitals into smaller, more specialized categories of facilities to better integrate them into the community appropriate for patients’ level of care needs and closer to their social support network. RCW Chapter 71.24 is the enacting legislation known as the Community Behavioral Health Services Act. RCW 71.24.015 states that "It is the intent of the legislature to establish a community behavioral health system which shall help people experiencing mental illness or a substance use disorder to retain a respected and productive position in the community.”

According to the Substance Abuse and Mental Health Services Administration (SAMHSA) one in five adults in the U.S. have a clinically significant mental health or substance use disorder. Yet, many people fail to receive treatment due in part to the long-standing shortage of behavioral health providers.

To help develop statewide behavioral health infrastructure, the Department of Commerce created a model ordinance, which provides guidance and best practices for local communities in siting and permitting these facilities.

There is a shortage of behavioral health services across Washington state, but especially in the South King County region. We want to hear from the community as we work through this process to identify appropriate facility locations and siting conditions.

What types of facilities will be in Kent?

The State’s Behavioral Health Facilities Model Ordinance identifies several types of facilities to meet different needs and levels of treatment. The City has received an influx of inquiries about two facilities that do not fit into current regulations in Kent City Code. These facilities are also ones that we have heard help meet the needs of our community.

Kent City Code includes several uses that may appear similar to these behavioral health facilities (assisted living facility, group home, residential facility with health care). However, after further review and evaluation, the City determined that these uses and development regulations do not sufficiently address the unique nature of behavioral health facilities, such as higher staffing ratios, security concerns, and number of treatment beds. To better serve the community, the City is proposing to revise development standards to add two new facilities:

1. Enhanced Service Facilities (ESF). These are residential long-term care facilities that provides support and services to persons for whom acute inpatient treatment is not medically necessary. Mental health treatment is not provided on site. The facility includes rooms for social activities and dining, bedrooms, bathrooms, a commercial kitchen, and offices. (RCW 70.97); (WAC 388-107)

and

2. Intensive Behavioral Health Treatment Facilities. These are facilities that provides 24-hour supervision and specialized treatment for individuals with behavioral health conditions, including individuals discharging or being diverted from state and local hospitals, whose impairment or behaviors do not meet, or no longer meet, criteria for involuntary inpatient commitment, but whose care needs cannot be met in other community placement settings. Residents are placed there voluntarily and may include short-term or long-term stays. (RCW 71.24.025 (29)); (WAC 246-341-1137)

In addition, the City will be updating permitting processes for consistency with Washington State’s Growth Management Act (GMA), which requires local government to allow essential public facilities in their jurisdictions (RCW 36.70A.200). Essential public facilities are uses that address needs of the state, region, or community and are typically difficult to site. Some examples include airports, correctional facilities, group homes, and inpatient facilities substance abuse and mental health facilities. While Kent must allow these uses, we retain significant discretion to identify the locations and conditions for siting the facilities.

New facility types continue to emerge as needs are identified and health practices evolve. To address this, the City is also updating the process for essential facilities to recognize new and emerging facilities when we may not have established permitting processes or development regulations to address these specific uses.

Last year, the State legislature added opioid treatment programs to the list of essential public facilities. Kent currently allows opioid treatment programs. As part of this update, the City is evaluating allowed locations and siting criteria for consistency with state law and to meet community needs. This includes a possible expansion to allow opioid treatment programs to be established near high-capacity transit in areas like Central Avenue and Pacific Highway.