MHS Provides Answers To Bonnieview Questions

[Bill Call]

I want to thank Eric Morse and others who worked hard to provide these answers. MHS provides a valuable service to the residents of Cuyahoga County and I thank them for that as well.

If anyone would like me to ask additional questions please send me a private message.

Mr. Morse has offered to meet with any group that has additional questions and concerns.


1. How many clients have been moved to Oak Tree Manor (Bonnieview)?
Twenty five clients have moved into the Oak Tree Manor

2. How many clients do you plan on moving to Bonnieview?
MHS has no plans to move any additional clients to Oak Tree Manor. However, it is
the landlord’s right to lease to other individuals who are supported by subsidies or housing vouchers.

3. How will your clients being housed in Tremont be moved to Lakewood?
Our clients were moved into Oak Tree Manor with the assistance of a moving company.

4. Who will pay for that transportation?
Payment for transportation was arranged by EDEN (Emerald Development and Economic Network), a non-profit housing developer in Cuyahoga County that administers housing subsidy programs.

5. If your client chooses not to relocate to Lakewood will other housing be available?
MHS clients are able to use vouchers anywhere they wish.

6. How will future tenants be moved to Bonnieview?
MHS has no plans to move additional clients to Oak Tree Manor.

7. How much rent is Mental Health Services paying for each of the apartments?
MHS does not pay rent for apartments at Oak Tree Manor.

8. How much was MHS paying for each unit for the apartments in Tremont?
MHS did not pay rent for apartments in Tremont.

9. What is the total security deposit paid by Mental Health Services?
MHS did not pay a security deposit.

10. Do you have a lease?
Each tenant has a lease with the owner of the building. Office space for staff is under negotiation.
• Please provide a copy of the lease
You would need to get this from the owner of the building.

11. Did you know that Big Oak LLC is delinquent on their property taxes?
No

12. Where did the transferred clients live before they were move to Lakewood?
We are unable to provide this information, as it is Protected Health Information (“PHI”) and further protected by the limitation imposed by section 149.43 and confidentiality rules from the Ohio Department of Mental Health.

13. What is the address?
We are unable to provide this information, as it is Protected Health Information (“PHI”) and further protected by the limitation imposed by section 149.43 and confidentiality rules from the Ohio Department of Mental Health.

14. Did you share that building with any other public agency?
Not to our knowledge

• If so what is that name of that agency?

15. Is that agency moving out of that building?
MHS is does not have knowledge of whether there is a public agency leasing space in the Tremont building.

• If not, why not?

16. What type of building violations led to the decision to move your clients?
MHS is not involved in these types of inspections and corrections, nor do we have comprehensive information regarding the violations in the Tremont building.

17. What specific violations led to the move to locate?
MHS does not have comprehensive information regarding the specific violations that led to the move.

18. Was the landlord given time to cure those violations?
MHS was not involved in discussions regarding the curing of violations.

19. What discussions took place between the management of Kingsway and MHS to correct the violations?
MHS was not involved in discussions regarding the correction of violations.

• Please provide copies of all correspondence between Mental Health Services and the owners of the Tremont property.
See number 16.

• Please provide copies of all correspondence between Mental Health Services and the City of Cleveland.
To our knowledge, there was no documented correspondence between MHS and the City of Cleveland regarding this.

20. Where do you live?
Does not fall within scope of ORC 149.43

21. Would you be comfortable having your clients as neighbors?
YES
• Why?
I would have no more hesitation living next to them as I would living next to anyone else.

22.ll any of those moved into Bonnieview have severe and persistent mental illness?
We are unable to provide this information, as it is Protected Health Information (“PHI”) and further protected by the limitation imposed by section 149.43 and confidentiality rules from the Ohio Department of Mental Health.

23. How do you define severe?
MHS is a contract agency of the ADAMHS board, and as such utilizes their definition of Serious Mental Illness. Severe is defined by the State of Ohio Department of Mental Health. “Pursuant to section 1912© of the Public Health Service Acts, adults with serious mental illness (SMI) are persons: (1) age 18 and over and (2) who currently have, or at any time during the past year had a diagnosable mental behavioral or emotional disorder of sufficient duration to meet diagnostic criteria specified within DSM-IV or their ICD-9-CM equivalent (and subsequent revisions) with the exception of DSM-IV ‘V’ coes, substance use disorders, and developmental disorders, which are excluded, unless they co-occur with another diagnosable serious mental illness. (3) That has resulted in functional impairment, which substantially interferes with or limits one or more major life activities. Federal Register Volume 58, No. 96 published Thursday May 20, 1993 pages 29422 through 29425.

24. Do any of the residents to be moved to Bonnieview have felony records?
We are unable to provide this information, as it is Protected Health Information (“PHI”) and further protected by the limitation imposed by section 149.43 and confidentiality rules from the Ohio Department of Mental Health.

• If so what are those felonies?

25. How many of your facilities are located in residential neighborhoods?
All of them

26. How many of your facilities are located in suburban areas?
One

27. Will MHS assume any responsibility for the conduct of its clients?
No
• If so, what are the limits of that responsibility?

28. Does your agency have liability insurance?
Yes

29. What are the limits of that coverage?
$1,000,000/ $3,000,000

30. Does your policy cover the conduct of the clients of MHS?
No

31. Does the MHS require the owner of Oakwood Manor to have liability insurance?
No
• If so, what are those requirements?
• If so, is MHS listed as an additional insured?
• If so, is the City of Lakewood listed as an additional insured?

32. What services will the City of Lakewood be obligated to provide to your
residents?
The City of Lakewood will provide identical services to the tenants of Oak View Manor as they do to all other residential areas of Lakewood.

33. Who will pay for those services?
The services provided by the City of Lakewood will be funded by whatever means the City routinely uses to support these services.

34. What affect does locating a homeless facility in a middleclass residential area have on the property values of that area?
Oak View Manor is not a homeless facility.

35. Was that a consideration or the part of any discussion?
No
• If so, provide the details.

36. Will MHS house any children in the facility?
Currently Oak View Manor has not leased an apartment to an individual with children. It is the landlord’s right to do so.
• If not, are there any plans to move children into Big Oak?

37. What type of special services will those children require?
MHS cannot predict the type of services that would be needed by children. In the event that a client with a child moves into Oak View Manor, MHS would identify resources and services that would be beneficial to their specific needs.

38. Why did you choose Lakewood?
MHS and EDEN looked at several buildings in Cleveland, Broadview Hts, Parma and Lakewood. This building best met the needs. We were looking for the right building, not a certain town.

39. What type of onsite mental health services will be provided?
Supportive services will be available at Oak View Manor. Supportive services help clients remain in housing, and live as independently as possible.

40. Do your residents have health insurance?
Clients of Oak View Manor may have Medicaid, Medicare or no health insurance.

41. Who is responsible for their health care?
Every individual is responsible for their own health care. Staff work with clients on identifying health care issues and steps to take to maximize their health, both psychiatric and physical.

42. What type of physical disabilities do your tenants have?
MHS is unable to provide specific information about the types of physical disabilities that clients have. In general, the physical disabilities that clients are challenged with are the same as those challenging other citizens of Lakewood. (Specific information is protected health Information (“PHI”) and further protected by the limitation imposed by section 149.43 and confidentiality rules from the Ohio Department of Mental Health. )

43. What type of treatment are they receiving?
MHS is unable to provide specific information regarding what types of treatments clients are receiving for their health care. MHS is a provider of case management, nursing, psychiatric and crisis services for Cuyahoga County. Clients of MHS are able to access services from us, or from other health care providers in Cuyahoga County.

44. Who provides that treatment?
MHS is a provider of case management, nursing, psychiatric and crisis services. We are able to provide those services to clients of our agency. Providers of those services must be appropriately licensed, as defined by the State of Ohio. Individuals who are clients of MHS are able to voluntarily participate in any of these services.

45. Who pays for that treatment?
Services are paid for through general funds from the federal or state governments.

46. If one of your clients needs the services of Lakewood’s EMS who pays for that service?
Should one of our clients needs services from Lakewood’s EMS, they will be responsible for payment in the same way as any other Lakewood resident.

47. If your clients needs emergency medical care who pays for it?
Client’s insurance
• Where did your clients in Tremont go for medical care?
We are unable to provide this information, as it is Protected Health Information (“PHI”) and further protected by the limitation imposed by section 149.43 and confidentiality rules from the Ohio Department of Mental Health.

48. If your clients are arrested who is responsible for providing them with a lawyer?
A client can arrange for his/her own legal representative or the court will provide a public defender.

49. Under what conditions do you deny further housing assistance to your clients?
MHS is not involved in housing assistance payments. In the event that the lease is violated, the landlord is able to exercise his legal rights regarding eviction, as defined in the lease.

50. Where do they go when that housing is denied?
In situations where it has been decided that a person is unable to remain in housing, MHS works with the individual on identifying other resources available (family, friends, shelter).

51. What type of conduct would be grounds for an eviction from your facilities?
The lease between the landlord and the client defines what conduct could result in an eviction.

52. Can you guarantee the safety of the residents in the surrounding area?
MHS can provide no guarantees about the safety of the residents in the surrounding area, nor can we guarantee the safety of our clients. We, as anyone else, are simply unable to provide guarantees about anyone’s safety, whether it is someone we are working with or not. We can, however, work with clients and residents to gain a more thorough understanding about mental health issues and the stigma that is attached to them. Mental health issues are not confined to those who have moved into Oak View Manor. There are many individuals living in Lakewood, as well as other suburbs, who struggle with mental health challenges.

53. Do any of your clients have a history of violent behavior?
We are unable to provide this information, as it is Protected Health Information (“PHI”) and further protected by the limitation imposed by section 149.43 and confidentiality rules from the Ohio Department of Mental Health.
• If so, what type of behavior?

54. Do your residents have any income?
While we are unable to provide specific information about the incomes’ of the individuals at Oak View Manor, many MHS clients have an income.

55. Do your residents pay anything for their housing or other needs provided by Mental Health Services?
MHS is not involved in housing subsidies. MHS does not require payment for any services provided, whether it be to these individuals, or to individuals who utilize the Suicide Hotline, or the Mobile Crisis Team.

56. Do any of your residents have a history of drug use?
A history of drug use is not uncommon in individuals who are receiving services from our agency. (We are unable to provide this information, as it is Protected Health Information (“PHI”) and further protected by the limitation imposed by section 149.43 and confidentiality rules from the Ohio Department of Mental Health. )
• What type of drugs?
• Who supplies those drugs?
• Do the suppliers deliver those drugs to the client or does the client have to buy in the streets?

57. Does MHS have a risk management strategy for the clients to be housed at Bonnieview?
I am hesitant to respond, as I am unsure what you mean by a risk management strategy. What I can say is that MHS has a long history of working with individuals in Cuyahoga County who are recovering from homelessness, mental health concerns, to include suicidal thoughts, as well as families victimized by homicides and violence. We work closely with each individual on creating an individualized plan, identifying ‘next steps’ to assist them in the recovery process. We are very much a part of that plan, as are other community resources that we identify with the individual, as being appropriate. I think of this, in one way, as a risk management strategy, as we are working with every individual on resolving issues and crises that are present in their lives, and moving toward a lifestyle that allows them to be self-sufficient and contributors to the community as a whole.

58. How can the people in the Bonnieview neighborhood help your clients?
Thank you. We truly do believe that we are good neighbors. And we understand that the passage of time is needed to show that. The people in the Bonnieview neighborhood can help by simply being neighborly, a smile, a hello. Stop in to the office and introduce themselves to staff. Call the office with any concerns. Understand that when we do not respond to some questions, it is because we are much like a doctor’s office. We have an obligation to protect the privacy and confidentiality of our clients, we are not trying to be secretive. We want the exact same thing that you do, a safe and friendly neighborhood in which to live.

59. What positive affect will the MHS move to Bonnieview have on the quality of life in the neighborhood?
We are hopeful that what we have seen happen at our other sites where supportive services are offered, happens here. The neighborhood either stays the same or, more often, gets better. We have support staff available, onsite 24 hours a day, providing another set of eyes to watch the neighborhood for safety concerns. Security cameras are installed on the outside of the building, to help with apprehending individuals who are behaving inappropriately, to include breaking the law. We know that this area has had challenges prior to our moving in. It is our hope that our presence may decrease some of the criminal activity in the surrounding areas.
As neighbors and Lakewood citizens get to know us, we begin to chip away at the stigma attached to mental health issues. Most Lakewood citizens do not know that we have been providing services to clients in Lakewood for many years. MHS staff have provided regular support to individuals challenged with mental health issues who live independently in their own apartments, without problem, in Lakewood. Oak Tree Manor is our first opportunity to do so with support services actually onsite. MHS partners with the Lakewood police to respond to children who have witnessed violence in their homes. This program (CWWV) has been recognized nationally because of the impact it has made on many young lives. We also work closely with the Lakewood police as early-responders to families who have lost a loved one to homicide. Lastly, we have been providing support services to anyone in Lakewood who has ever picked up the phone and called the Suicide Hotline for support. We are the voice on the end of the line. We dispatch teams to outreach to any individual in Cuyahoga County who is experiencing a psychiatric crisis. We have been a presence in the lives of Lakewood citizens for many years. It is our hope that this presence and our partnerships will increase.

60. What negative affect will the MHS move to Bonnieview have on the quality of life in the neighborhood?
We foresee none!

61. What is your policy regarding aggressive behavior?
We respond to any criminally aggressive behavior consistently: we contact the police. It does not matter whether the perpetrator is a client or not! We strongly encourage our neighbors to do the same. If the behavior is self-injurious, we contact the Mobile Crisis Team and attempt to de-escalate the situation until they arrive. (Incidences of violence and aggression are much higher in the general population than in those who are challenged with a mental illness.)

62. Does that policy include conduct outside the building?
YES. We contact the police when we are aware of any behavior that we believe may be against the law, regardless of who the individual is. We are committed to living in a safe neighborhood.

63. Does that policy cover behavior in the neighborhood?
YES! Same as above!

64. Do you have a warnings and exclusions policy?
Bill, we may but I don’t recognize that term.
• If so please provide a copy.

65. Does MHS have a written code of conduct for its housing clients?
No. The client enters into a lease with the landlord.
• If so, please provide a copy.

66. What type of services will be provided to your clients at Bonnieview?
Clients living in Oak Tree Manor have access to case management and life skills training to assist them with achieving life goals such as residential stability, increased income, and general well-being. They are able to access other services as well, to include nursing, psychiatric and crisis services.

67. What type of night time security will be provided?
MHS staff will be on-site 24 hours per day. This is not inclusive of a security officer.

68. Will there be a MHS representative on site at all times?
Yes

69. What are your minimum standards for dealing with serious incidents?
Any incident involving the breaking of a law is handled by the police. All serious incidents are reviewed by the Program Manager and Director and, depending upon what is involved, may involve our crisis team, medical director, senior management, County/State representatives etc. We do not have minimum standards for a serious incident.

70. How long do you keep written records for serious incidents?
All written records are retained for 7 years

71. Are those records available for public viewing?
We are unable to provide this information, as it is Protected Health Information (“PHI”) and further protected by the limitation imposed by section 149.43 and confidentiality rules from the Ohio Department of Mental Health.

72. Will the MHS report all serious incidents to police?
ALL serious incidences involving criminal activity will be reported to the police.

73. Under what conditions will serious incidents not be reported to police?
Incidences that do not involve criminal activity will not be reported to the police.

74. Does MHS assume any financial responsibility for the actions of its clients?
No

75. Is there any history of violence against the staff of MHS?
We would love to be able to respond to this question. Instead I am only able to point out that there are many, many situations in which individuals act out aggressively against co-workers, supervisors, strangers, etc. We are unable to provide this information, as it is Protected Health Information (“PHI”) and further protected by the limitation imposed by section 149.43 and confidentiality rules from the Ohio Department of Mental Health.
• If so, please provide the details.
• If so, please provide copies of the police reports.

76. What is the expected turnover rate for the Bonnieview building?
We do not know what the turnover rate for the Oak Ridge Manor will be. In our previous experience at other locations, turnover has been low.

77. Will new residents be screened for criminal records?
It is our understanding that the landlord does a criminal background check

78. Will those with criminal records be denied housing at Bonnieview?
That is up to the landlord

79. Will sex offenders be denied housing at Bonnieview?
No registered sex offenders are not allowed to live this close to a school

80. How much money does MHS receive each year from the State of Ohio?
Last year the Ohio Department of Development reimbursed MHS $144,829 for contracted services. The grant cycle ends February 28, 2010 and there is no guarantee that funding will be renewed. $19, 694 was received from The Ohio Department of Mental Health. This was one-time funding.

81. What is the source of those funds?
The Ohio Department of Development and the Ohio Department of Mental Health

82. How much money does MHS receive each year from Cuyahoga County?
MHS received $6,846,215 last Fiscal Year (July 1 – June 30).

83. What is the source of those funds?
Primarily Health & Human Service Levy Dollars

84. How much money does MHS receive each year from the Federal Government?
Last Year MHS received the following amounts from the Federal Government: $4,399,837 HUD; $2,880,713 Department of Health & Human Services; $66,139 U.S. Department of Homeland Security; $36,152 U.S. Department of Justice

85. How much money does MHS receive each year from donations from foundations?
$365,323 last fiscal year

86. What are the names of those foundations?
Skirball Foundation, Bicknell Fund, St Lukes Foundation, Elizabeth Severence Prentiss Foundation, Famicos Foundation, Hankins Foundation, Sisters of Charity Foundation, The Corporation for Supportive Housing, The Woodruff Foundation, The Giant Eagle Foundation, The Plain Dealer Charities

[Danielle Masters]

Thank you Bill. I do hope these answers alleviate some of the fears that residents have and that they better understand how much support there will be for these residents.

[Kate McCarthy]

I was very unimpressed with Mr. Morse's answers. Of course he cannot divulge PHI, but MHS does not seem to want to own much of the responsibility for this decision. My general impression remains this was an easy way to quickly move clients from one inappropriate setting into potentially another. I would really like to know what criteria were used to determine that Oak Tree Manor was the most appropriate building. Was it because it was the most vacant, had the most desperate landlord, or its proximity to an EDEN-owned property on Bonnieview? If they didn't bother to check whether the owner paid his property taxes, did they check to see how well the property is maintained, if utilities for the property are paid, if the snow is plowed from the parking lot in such a way as to force residents of the building to walk in the street to leave the building (I threw that in because that is how they plow the snow)? I would like to think that MHS and EDEN use some standards to determine if they are dealing with a slumlord or a responsible landlord before they move their clients into a building, especially since, from what Mr. Morse said, all of the responsibility of dealing with the landlord lies with the client once he or she is moved into the building.

If this was the building that “best met the needs” I would like to see those “needs” specifically spelled out.

[sharon kinsella]

Just sounding in a couple of things -

For questions about Eden Corp and their policies, contact them directly. They are a separate agency.

The apartments at Gordon Square are also made up of many MHS clients and I know that they have a LSW on staff all the time to handle any situation and because they are an LSW they are empowered to pink slip - commit to a psychiatric facility, someone exhibiting crisis behaviour.

The Crisis Team and Suicide hotline run by MHS are two of the best of their kind in the country.

Most of the MHS clients probably are paying their rent through the Section 8 program providing help for those with severe mental issues. For that information, you would contact Cuyahoga County for the correct agency and contact person.

I won't tell you where they are, but there are many apartments in Lakewood with a high population of tenants with severe mental health issues.

Whether you know it or not, your next door neighbor would be a different person without their medication. Don't assume that anyone with a mental issue is a degenarate and a risk to society. There are so many people, that you don't know of, that have the same issues. One pill away from a break down.

[Danielle Masters]

I echo a lot of what Sharon said. And I have to give major accolades to mobile crisis, they are a wonderful team that treat people with the care and respect they deserve.

[Richard Cole]

I echo a lot of what Sharon said. And I have to give major accolades to mobile crisis, they are a wonderful team that treat people with the care and respect they deserve.

That is very true - MHS provide a number of crucial services.

What I have problems with is, the MHS website indicating 58 Units at Oak Tree Manor, and replying to Bill's list of queries only 25 clients have moved from Kingsway Manor and no plans to move any additional clients to Oak Tree Manor.

I wonder why in response to Bill, the phrase "supportive services" is used, but on the description of the programs at Kingsway Manor, now the Oak Tree Manor site, MHS uses the phrase "intensive treatment and supportive services".

After reading the comprehensive list of questions and answers, I can't help but feel that the program(s) offered by MHS as described on their website, do not meet the criteria of an R2 zoned area.

It will be an interesting Board of Zoning Appeals meeting this evening.

[Jim O'Bryan]

Bill

Good work as always, thank you.

One thing that I would like to remind all, is that this is not a separate incident unto
itself. This is one group of many now in Lakewood. Filing apartments on Lake, Clifton,
Detroit, Madison.

While MHS should be applauded for coming forward with answers, which as Sharon points
out is very rare in this city. Are we so "lucky" with others trying to be good neighbors.

What if any control/oversight is being put on these groups,or are we destined to live in
the middle of a halfway house for the county?

FWIW


.

[Bill Call]

I wonder why in response to Bill, the phrase "supportive services" is used, but on the description of the programs at Kingsway Manor, now the Oak Tree Manor site, MHS uses the phrase "intensive treatment and supportive services".

After reading the comprehensive list of questions and answers, I can't help but feel that the program(s) offered by MHS as described on their website, do not meet the criteria of an R2 zoned area.

The Board granted the continuance requested by Big Oak’s attorney. The next scheduled meeting will be sometime in November. The attorney indicated that the owners would like to seek some kind of compromise with the City.

Councilman Kevin Butler, who has been on top of this issue from the start, asked that opponents of the MHS move limit their discussion to the change of use. He indicated that it is a waste of time to complain about the type of people who are living there or to complain about section 8 in general. I agree. You are not going to win that argument. I was impressed with his presentation.

After the Board closed the meeting Ryan Demro asked that those who came to speak be allowed to speak. That request was granted. Most who spoke offered complaints about the conduct of the tenants and complaints about section 8 in general. I spoke (always a big mistake) for a couple of minutes.

I said that the building owners had so mismanaged their building that they were facing foreclosure and that they had so neglected their building that it was nearly empty until they were rescued by MHS (aka your tax dollars).

I pointed out that the few remaining non subsidized tenants that lived there would be moving out and that it was a near certainty the building would soon house only mental health clients. I opined that if you had a building housing only mental health patients and offices in that building that offered treatment and support services the building is no longer an apartment building but a mental health service center. The building is not zoned for that use.

Some attendees expressed frustration with the process and the Board. I would like to point out that the Board is not a Star Chamber. The Board must follow the law, the ordinance and the precedent. They cannot and should not let their personal feelings affect their rulings.

Members of the Board are Lakewood citizens who volunteer for this important service. Keep that in mind if you attend the next meeting.

It was a pleasure meeting you Mr. Cole. Is there any way you can write in your very pleasant English accent so other's can enjoy it?