ALFS and the Mentally Ill

Posted in: Historic Old Northeast
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During discussions among neighbors regarding the proposed CVS project, complaints were voiced regarding the disproportionate number of Assisted Living Facilities with Limited Mental Health Licenses that exist in the city, amny within the NSN, and regarding disturbing conduct by people we are assuming are this population. Here is some information for you to consider and some ideas to address this neighborhood issue that will not go away with the demise of Watson's.

There are approximately 3,000 adult chronically mentally ill persons in the city. During the late 60s and 70s, the federal government funded comprehensive community-based mental health systems and rehabilitation centers like Boley Manor to deinstitutionalize this population from horrendous, warehouse-like conditions in state hospitals. With political changes, federal and state funds for deinstitutionalization dwindled, devastating these programs, while the government push to diminish and close state hospitals continued.
So, on any given day in Pinellas County, 300 to 400 mentally ill are housed and treated in the local jails due to minor charges most often related to their deteriorated mental conditions.

In St. Petersburg, Suncoast Mental Health Center serves the 3000 clients mentioned. Due to little funding, only 500 qualify for Case Management services, services designed to monitor these clients closely; see that they have housing; that they are keeping their treatment appointments; that they are adequarely cared for in the ALFS in our neighborhood and nearby, etc. These clients see a Psychiatrist for medication management on the average once every 3 months. Suncoast also provides a drop-in center at around 15th Ave. and 4th St. N., where this population can come daily for socialization and services to link them to needed help. But, some of those who visit this center are those difficult to engage in treatment services. In the past, clients who destabilized and required hospitalization could stay long enough for changes in medications to be made and reviewed, sometimes two to three weeks or longer if truly needed, but today, are only funded for 2-3 days--not even long enough to evaluate the effectiveness of changes in treatment. Economically, most of these clients subsist on less than 550.00 a month, and if they live in an ALF, that money pays for their housing, and they receive 42.00 a month ''personal money.'' And so, this abandoned and inadequately supported population are more visible to us.

I have to end this now to get to an appt., but stayed tuned for some ideas regarding actions we could take to try to improve this situation for our neighborhood and community.
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ALFS and Mentally Ill Cont'd

Boley Manor is the local rehabilitation program that provides various kinds of housing for the mentally ill plus vocational rehabilitation, case management, and other services to help once institutionalized clients to adjust to community life. During the days of deinstitutionalization when Boley Manor and Suncoast Mental Health facilitated the relocation of State hospital patients to St. Petersburg, the City responded to need for housing and probably to reassurances of adequate supportive services and permitted a disproportionate number of ALFS to be established in the NSN and nearby areas. Many existing ALFS were ''grandfathered in'', and now the City Ordinance reads that no new ALF may be permitted within 1200 feet of an existing one, although there is a process to gain exceptions. These are the underlying reasons why NSN residents are experiencing problems with this population, and replacing Watson's will not solve these problems.

The Agency for Healthcare Administration licenses these homes, regulates them through rules, and monitors them, but these are open, voluntary settings where clients self-administer medications, cannot be forced to take medications or to participate in treatment, and live fairly independently. People who run ALFS must receive only 6 hours of training.

Here are some ideas to consider for those who would like to try to improve this situation:
NSNA could form a small committee to work with the City Planning Dept. regarding new requests for permits and to work toward changing the ordinance to decrease the number of ALFS in our neighborhood.
Confront our State legislators about the poor funding for this population. At our recent General Membership Meeting, Frank Farkas stated that he supported a 13 million dollar increase in funding for Mental Illness/Substance Abuse Treatment statewide. How much of that funding will go toward the newly developed community teams of mental health professionals, each of which will provide intensive outpatient services (as much as daily contact if necessary)to 100 severely mentally ill clients per year at a cost of 10,000 dollars a client, dramatically less than the cost of state hospitalization or treatment in a jail setting?? Contact your legislators and tell them you want these teams funded, that you want increased Case Management and inpatient Crisis Stabilization funds for this population. Write your Federal legislators and confront them about their abandonment of these citizens.
On a day to day basis locally, if NSN residents can manage to identify the ALF where a problematic, acting-out client resides, I have a committment from the CEO and Supervisor of Case Management at Suncoast Mental Health to assist by making a visit to the ALF, assessing the client, etc.
Make private donations to Suncoast and to Boley Manor.
Join the local Mental Health Association.
Any NSN resident who is interested in pursuing this issue further, please contact me. We can continue to call the police when we are disturbed by these clients' conduct, and we should, but incarceration and treatment in jail is costly and a poor solution to this problem.

thanks for all info

Thank you for all this very valuable information. If I have read it correctly, new ALFs could be opened within NorthShore, as long as they are not within 1200 feet of an existing ALF.

This is very startling because NS is already carrying more than its fair share of these facilities and has many older, large homes and apts. which could be easily converted for such a use.

I would encourage you to write this information in an article form for the next newsletter that goes out to the whole neighborhood. This is important information that everyone should be made aware of.

Also, if we have a list of the ALFs in Northshore, is it posible for us to make sure that the clients are being adequately cared for? This is a way we might be able to help these unfortunate people.

Again, thank you for your time in researching this and for sharing this info.


By Anna
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You are welcome...

You're welcome, Anna. I will be providing a concise version of this info. for the Aug. newsletter. In terms of whether these residents are being adequately cared for, ALFS are regulated and monitored by the Agency for Healthcare Administration, and I'm in the process of getting specific info. on licensing requirements and procedures for monitoring the quality of care in these homes and will pass on whatever I learn. The critical dilemma is that these residents cannot make a good adjustment to living in the community without good quality mental healthcare and substance abuse treatment(many have a mental illness plus alcoholism), and these services are woefully underfunded by both state and federal government.
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