HomeMy WebLinkAboutAttachment 7.g.i. - Public Comments No 1PUBLIC COMMENT LETTERS NO. 1
Caroline Youn
From Patricia Salvacion
Sent: Thursday, May 23, 2019 9;51 AM
To: Caroline Young
Subject FW: Psychiatric Hospital in Eastlake
From: Leah Hurtado <I__.. ........... __,._ ,
Sent: Thursday, May 23, 2019 8:39 AM
To; Patricia Salvacion <psalvacion@chulavlstaca.gov>
Subject: Psychiatric Hospital In Eastlake
Patricia,
I am writing you regarding the proposed Eastlake Psychiatric Hospital. I have been actively researching
facilities such as these and am concerned about the currently proposed location.
Psychiatric hospitals are needed in San Diego but R is of utmost Importance that the proper site be selected to ensure the
preservation of current neighborhood character, patient safety, community safety and facility success.
... .. Building a regional hospital far from mass transit, most easily accessible by toll road needs better vetting. Asyou know It's
nestled within a neighborhood and surrounded by a vulnerable population comprised of families with children. My
concerns are directly connected to the fact that elopements (escapes) are an expected event within hospitals. Both for
involuntary patients and voluntary. Because of the.wide range of mental illnesses being treated at this facility, elopement In
a heavily concentrated area with vulnerable populations significantly increases the chances of a dangerous event occurring.
Can Acadia please share the number of elopements they had per faculty in 20187
I'd like to share this article with you regarding elopement:
https://www asychiatricnumine ore/article/50883 9417(12)00129 X/pdf
Having 24 hour security will not completely guarantee the surrounding communities the safety we deserve.
My understanding is that you are only required to notify people within 500ft of the site please make sure to include me In
the notification sent by the city. You may do so via email. -
Thank you,
Alex Hurtado
Sent from my !Phone
Caroline Youn
From:
Patricia Salvation
Sent
Thursday, May 23, 2019 12:02 PM
To:
Caroline Young
Subject:
FW: Relocate Eastlake Behavioral Health Center
-----Original Message -----
From: Maly Quinto
Sent: Wednesday, May 22, 2019 10:14 PM
To: Patricia Salvation <psalvacion@chulavistaca.gov>
Subject: Relocate Eastlake Behavioral Health Center
Warning: External Email
Dear Patricia:
As a healthcare provider I have valuable insight into the reality of the inner workings of the health
field. Scripps has promised many things but in my experience there is human error and mistakes
happen.
This is understandable and expected but when a facility with high risk is located literally steps
away from places highly concentrated with family and children, it is unacceptable. Chula Vista is
already. documented to have substandard response times for police and emergency calls, and this
problem is worse in East Chula Vista, where this facility is as far east as it could possibly get.
I am a resident of Rolling Hills Ranch, adjacent to the site. We live so close I will be able to see
the hospital from my master bedroom window. That same view overlooks my child's school bus
stop, which is a mere 100 It from the proposed property Be, close enough to toss a ball over. We
moved herein part because we knew the community, surrounding parks and trails, and business
composition are already well-established as safe and family-oriented. This new facility will stand
in stark contrast to all of that.
Enough of.us have emailed you now that I have already seen and know what to expect in response
to this email. You will tell me "a broad search" was conducted that "located land in Chula Vista
that was most appropriate." I challenge that assertion and want to know the details of how you
came to that conclusion. What criteria does this location meet that isn't better met in dozens of
other places? Did your criteria take distance from the replaced hospital into account?
Public transit times? Have you surveyed existing patients and staff for their preferred locations
from those available? If you did any of these you would quickly find that this is possibly the
worst or least desirable location you could have chosen based on those factors. When we moved
here even our closest friends and family don't visit as much because of the inconvenience and cost
of the 125 toll road. A bus ride from La Mesa to the proposed site would take 3 hours each way,
Would a person seeking care endure 6 hrs on the bus for an appointment?
Indeed your desire to help those in dire need are at odds with the inconvenience of this location.
You will also tell me that "the facility will have 24-hour security," but said security will likely be
provided by partner Acadia, 80% owner and operator, a company whose promises and guarantees
carry little weight when you look at their well publicized recent history of neglect and fraud. in
fact the need for 24-hr security is even less assuring because this would be the first and only
facility requiring that level of security, and implies the dangers associated with it.
You will say this facility "will provide safe, quality care for patients who are greatly underserved."
That sounds great and is a good thing but what happens to the underserved after they leave your
doors, into the surrounding community? Any guarantees you provide are of little assurance when
you couldn't possibly guarantee where cases of elopement or discharged high risk patients decide
to go from there.
Scripps has a well respected reputation in San Diego County. Ask
yourself if it's a good idea to risk sullying it by partnering with the high risk company Acadia in a
location with high risk of damage to that reputation? I'm sure that the facility will be a great and
valuable asset to San Diego, but because it's for all of San Diego, please find the best location for
its patients, physicians, and staff, that's a better fit with its surroundings and better supported by
proximity to hospitals and public services.
Concerned resident,
Maly Quinto
Caroline Youn
From:
Patricia Salvacion
Sent
Thursday, May 23, 201912:02 PM
To:
Caroline Young
Subject
FW: SPECIFIC CONCERNS REGARDING PROPOSED PSYCHIATRIC HOSPITALS IN EASTLAKE
From: Aileen Andel c
Sent: Wednesday, May 22, 201910:39 PM
To: Kelly Broughton <kbroughton@chulavistaca.gov>; Patricia Salvation <psalvacion@chulavistaca.gov>;
montano.monica@scrippshealth.org
Subject: SPECIFIC CONCERNS REGARDING PROPOSED PSYCHIATRIC HOSPITALS IN EASTLAKE
Hit I am a resident here In Eastlake and together with most of the residents here, 1 oppose to the planned
building of the 120 bed Psychiatric Hospital here in Eastlake. I strongly agree with the following concerns that
we residents all share and have detailed below:
*Distance from Ince rated Healthcare and limited accesalblllty This facility will be 20 miles away from Scripps Mercy
Hospital in Hillcrest, far removed from much of the populatlon it currently serves. How will patients get to this location with
limited public transportation and quick accessiblllty only avallable via toll road?
"Release Concerns and Escape Risk: What will happen to patients when they are released and refuse help from a social
worker? What happens when patients lack housing, access to additlonal medical care, or a family/support system to assist
them?
'Proximity to Children: Increase In traffic, tottering, and homelessness create safety concerns for the many schools, parks,
and day care centers that are in the neighborhoods immediately adjacent How will this be addressed?
"Limited Police & Reaources: Adding a new facility of this scale w01 likely cause an Increase in call volume resulting In an
increase in response time from ambulances, fire, and police. Chula Vista currently does not have enough police and Eastlake
has the fewest patrols assigned to handle issues arising from the facility or from those released. CVPD has the lowest sworn
officer-to-populatlon rata in the county at less than 1 sworn officers per 1,000 residents. How will this be addressed?
My understanding is that You are only required to noffy g"ple within WOft of the site please make sure to Include
me in the notification sent by the city. You may do so via email
Concerned Resident,
Aileen Jarina
Caroline Youn
From:
Patricia Salvacion
Sent:
Thursday, May 23, 20191203 PM
To:
Caroline Young
Subject:
fW: Eastlake Psychiatric Hospital
From: Behnam Radi
Sent: Wednesday, May 22, 201911:43 PM
To: Patricia Salvacion <psalvacion@chulavistaca.gov>
Subject; Eastlake Psychiatric Hospital
Dear Patricia Salvaclon,
lam an Eastlake resident who lives less than 700 feet away from the proposed hospital location. Asa health care provider,
who has experience working with psychiatric population, I understand the importance of establishing new mental health
facilities in San Diego to ensure well-being of our communities. Also, my partner who is a provider at Scripps, serves the
some psychiatric patient population. However, both my partner and I believe that the proposed location for this facility is
far from optimal and falls short of property serving its patients and the immediate communities surrounding it. We have a
number of concerns that we would like to have addressed regarding the Psychiatric Hospital Proposed for 350 Showroom
PI.
I) Distance from Integrated Healthcare and limited accessibility:
Eastlake is a relatively remote area. This facility will be 20 miles awayfrom Scripps Mercy Hospital in Hillcrest, far removed
from much of the population it currently serves. How will patients and their families get to this location with limited public
transportation and quick accessibility only available via toll road? How will the discharged patients and their visiting families
commute to their homes or shelters? Wouldn't a more central location in San Diego with plenty of public transportation
serve such a vulnerable population better?
2) Release Concerns and Escape Risk
What will happen to patients when they are released and refuse help from a social worker? What happens when patients
lack housing, access to additional medical care, ora family/support system to assist them? Wouldn't that increase
homelessness. in Eastlake communities which are absolutely not prepared and structured enough to accommodate such a
vulnerable population?
3) Proximity to Children:
Increase in traffic, loitering, and homelessness create safety concerns for the many schools, parks, and day care centersthat
are in the neighborhoods immediately adjacent. How will this be addressed?
4)Limited Police & Resources
Adding anew facility of this scale will likely cause an Increase in call volume resulting in an increase in response time from
ambulances, fire, and police, Chula Vista currently does not have enough police and Eastlake has the fewest patrols
assigned to handle issues arising from the facility or from those released. CVPO has the lowest sworn officer -to -population
ratio in the county at less than 1 sworn officers per 1,000 residents. How will this he addressed?
5) Poor record of Acadia as a partner
Acadia Is reported to have 80% ownership of this new facility. Acadia has not demonstrated the proven excellence with
managing behavioral health facilities needed to earn my trust and to allow me and my family to feel safe. There have been
dozens of articles showing Acadia's mismanagement. The documentations are filled with lawsuits, County Mental health
violations, elopements, Federal investigations, Incident reports of death, rape, abuses, negligence and fraud. We are
skeptical that Acadia will show enough competence in serving such a vulnerable patient population on one hand and
ensuring the safety of the adjacent communities, on the other hand. This is net a partner we trust and want in our
community, let alone our neighborhood.
I really appreciate it If you keep the concerns of our communities in mind before allowing establishment of this facility in
the proposed location and relocate it to a more appropriate location for both the patients and the surrounding
neighbonccods.
My understanding is that you are only required to notify people within 500ft of the site please make sure to Include me in
the notification sent by the city. You may do so via email.
Sincerely,
Concerned Resident,
Behnam Radi
Caroline Young
From:
billstellln _.._..
Sent:
....._,_..__.__...
Thursday, May23, 2019 12:25 PM
To:
Caroline Young
Subject
Open Letter -
05/23/2019
To Whom It May Concem,
As a former employee of a psychiatric hospital who worked in the field for years with a degree in Psychology, as well as a
resident of the Rolling Hills Ranch community in Chula Vista, I'd like to express some professional concerns related to the
proposed building of a psychiatric facility at Showroom Place in Chula Vista.
The facility I worked at was both an outpatient and inpatient hospital, similar to the proposed hospital being built. We
addressed a large variety of needs for the community. There is a stark contrast between what occurs in an inpatient, secured
wing and what occurs in an outpatient wing. The patients in the inpatient wing were typically brought in by Police or
Ambulance and were labelled as 5150's (a danger to self or others). These patients were often homeless and were usually in
the middle ofa psychotic break from reality. They were typically very violent (assaults against staff were a daily occurrence),
and much of my time as an employee was spent restraining these patients, watching them get secured to a bed, and frrcefully
injected with psychotropic medications.
These patients would spend a few days at our facility, and after being forced to take medications, many of them
would eventually stabilize. Upon stabilization, and after their holds were rescinded, many of these patients simply walked out
the front door and into the community. The vast majority of them did not have family or friends to pick them up, and they did
not have the ability to adhere to any aftercare programs. Although it was technically company policy to not release stabilized
patients out the front door, this was not the common occurrence. It is absolutely within a patient's legal right to refuse service
after stabilization, and refuse further assistance, including transportation, and it is within their legal rights to simply walk out
the facilities front door on their own accord.
This form of releasing of patients impacted the community surrounding the hospital I worked at. It was one of the
only facilities in the county, and many homeless and mentally ill people gravitated towards it, as it became part of their
lifestyle to be admitted into and released from these hospitals. This increased homelessness and crime in the area, and it was
commonplace to have mentally ill people walking through the community, The hospital became a beacon for many people,
and was used as.a place for "I7vee Hots and a Cot' (three warm meals and a place to sleep). The vast majority of patients on
our inpatient wing had long criminal histories. This system is easily abused, and repeat patients were standard.
I will cite one example from my experience (of many). We had a homeless patient who arrived at a hospital
complaining that his hand hurt so badly that he wanted to kill himself. After being medically examined, it was determined
that the man bad bitten his own thumb off, and shoved it up his own rectum. Doctors found other things besides his thumb up
there as well. The patient was brought to us on a 5150 psychiatric hold. He was combative towards staff, and assaulted a
nurse. He tried to escape and kicked out a facility intake window. He was incredibly strong and it took almost all of the on
site staff to restrain him so that he could be administered sedatives. He eventually stabilized, but he had nobody to pick him
upi and had no home to be taken to. He was simply released out the front door upon his own request, and slept in a park about
a block away, amongst some other homeless patients that frequented our hospital.
From my own professional opinion, and from my own personal experience, this hospitals location to single family
homes, schools, community parks, and child focused businesses poses as a significant threat to the local community.-
Corporate policy can only govern what occurs inside of a facility, and without a massive increase in police patrols in our
area, an increase in local aftemare programs close to the hospital, as well as a major overhaul to patients civil rights, the
potential for threatening situations for the local community is far too great to allow_ this hospital to be built. I can absolutely
guarantee that it is not a matter of "if' something happens, but of "when".
The historically negative reputation of Acadia (the company building this hospital) is well documented, not only in
media reports, but in lawsuits, federal investigations, and from state inspection reports. They are notorious for safety
violations, and lack of proper patient care. Not only is the site location an improper location for such a facility, but the
company building this hospital can not be trusted to keep their own patients safe, nor the members of our community. Plesse
remember that this is a for-profit mental health facility, and [bat substantial research exists outlining the fundamental failures
of "for-profit" mental health hospitals, and their utter disregard to patient and community safety.
I implore you to please protect our community and the vuhrerable citizens who live here, by denying the building of
this facility in it's currently proposed location. Please look elsewhere for a more appropriate and Icss dangerous location.
Sincerely,
William Stellin
Caroline Young
From:
Patricia salvacion
Sent
Thursday, May 23, 2019 12:01 PM
To:
Caroline Young
Subject
PW: Eastlake Psychiatric Hospital
From: Kimberly Berry
Sent: Wednesday, May 22, 2019 8:59 PM
To: Patricia Sa Wcion <psalvacion@chulavistaca.gov>
Subject Eastlake Psychiatric Hospital
Hello Patricia,
I am an Eastlake resident . I have a number of safety concerns that I
would like to have addressed regarding the Psychiatric Hospital Proposed for 350
Showroom Pl.
Distance from Integrated Healthcare and limited accessibility: This facility will be 20
miles away from Scripps Mercy Hospital in Hillcrest, far removed from much of the
population it currently serves. How will patients get to this location with limited
public transportation and quick accessibility only available via toll road?
Release Concerns and Escape Risk: What will happen to patients when they are
released and refuse help from a social worker? What happens when patients lack
housing, access to additional medical care, or a family/support system to assist
them?
Proximity to Children: Increase in traffic, loitering, and homelessness create safety
concerns for the many schools, parks, and day care centers that are in the
.neighborhoods immediately adjacent. How will this be addressed?
Limited Police & Resources: Adding a new facility of this scale will likely cause an
increase in call volume resulting in an increase in response time from ambulances,
fire, and police. Chula Vista currently does not have enough police and Eastlake
has the fewest patrols assigned to handle issues arising from the facility or from
those released. CVPD has the lowest sworn officer -to -population ratio in the county
at less than 1 sworn officers per 1,000 residents. How will this be addressed?
My understanding is that you are only required to notify people within 500ft of the
site please make sure to include me in the notification sent by the city. You may do
so via email.
Concerned Resident,
Kimberly Berry
Sent from Gmail Mobile
Caroline Young
From:
Patricia Salvacion
Sent:
Thursday, May 23', 2019 12:01 PM
To:
Caroline Young
Subject:
FW: Eastlake Psychiatric Hospital
From: Kerri Lindgren, _ _
Sent: Wednesday, May 22, 2019 10:12 PM
Subject: Eastlake Psychiatric Hospital
To Whom It May Concern:
I'm writing to you in regards to the proposed psychiatric hospital.
I am certain that this is not
an appropriate location for such a large facility and oppose it being built on Showroom Place.
.. My understanding Is that you are.only required to notify people within S00R of the site please make sure to Include me in
the notification sent by the city. You may do so via email.
Thank you,
2
Caroline Youn
Rom:
Patricia Salvation
Sent:
Wednesday, May 22, 2019 11:D4 AM
To:
Kelly Broughton; Caroline Young
Subject:
FW: Psychiatric Hospital on Showroom Place
Sharing..
_._...
From: an Burger ._..__...
Sent: Wednesday, May 22, 2019 7:54 AM
To: Patricia Salvation <psalvacion@chulavistac"ov>
Subject: Psychiatric Hospital on Showroom Place
MIaFNq�:
it r Patricia,
I am an Eastlake resident .1 have a number of safety concemsthat I would like to have addressed regarding
the Psychiatric Hospital Proposed for 350 Showroom PI.
Distance from Integrated Healthcare and limited amessibilhy: This facility will be 20 miles away from Scripps Mercy Hospital
in Hillcrest, far removed from much of the population it currently serves. How will patients get to this location with limited
public tra nsportation and quick accessibility only available via toll road?
- Release Concerns and Escape Risk: What will happen to patients when they are released and refuse help from a social
worker? What happens when patients lack housing, access to additional medical care, or a family/support system to assist
them? -
Proximity to Children: Increase intraffic, loitering, and homelessness create safety concerns for the many schools, parks,
and day are centers that are in the neighborhoods Immediately adjacent. How will this be addressed?
Limited Police & Resources: Adding a new facility of this scale will likely rause an increase in call volume resulting in an
increase In response time from ambulances; fire, antipolice. Chula Vista currently does not have enough police and Eastlake
has the fewest patrols assigned to handle issues arising from the facility or from those released. CVPD has the lowest sworn
cficer-to-population ratio In the county at less than I sworn officers per 1,000 residents. How will this be addressed?
My understanding is that you are only required to notify people within 500ft of the site please make sure to Include me In
the notification sent by the city. You may do so via email.
Concerned Resident,
Ian Burgar
Sent from my :Phone
Caroline Youn
From:
Patricia Salvadon
Sent: -
Wednesday, May 22, 201911:04 AM
To:
Caroline Young
Subject: -.
FW: PLEASE HELP US PROTECT OUR COMMUNITY, OUR FAMILIES, OUR CHILDREN
Sharing...
From: Aileen Andal <
Sent: Wednesday, May 22, 2019 2:10 AM
To: Kelly Broughton 4broughton@chulavistaca.gov>; Patricia Salvaclon <psalvacion@chulavistaca.gov>
Cc: montano.monira@scrippshealth.org
Subject: PLEASE HELP US PROTECT OUR COMMUNITY, OUR FAMILIES, OUR CHILDREN
MEMO)
Hit I would like to thank you first for your service to our community. I am one of the many residents of Eastlake
area who are veryconcerned about the planned construction of the 120 -bed Psychiatric Hospital here In
- Eastlake, I think that I can speak for the many who believe that this specialty hospital is very much needed BUT
also believe that it needs to be built In an appropriate location. As from what I have read, this facilityserves as part of the
relocation and expansion of the 36 bed behavioral health facility of Sonpps in Hillcrest. I was also told that this would be the
2^ largest mental facility in San Diego. If I understand It right, this hospital men should serve the central and north areas as
well. I do find it hard to believe that they find the middle of Eastlake accessible for patients coming from central and north
areas. Also, I know that this is a specialty hospital that will be designed to address the mild and the extreme cases of mental
Illness. I think that we all realize the obvious and known dangers that may come from such a facility. As a mother I would
like to appeal to the City planning committee to please make a VERY RESPONSIBLE decision on this. As for any matter, I
think that SAFETY should always be pdority.. I think that the neighborhood's safety is much more Important than the 100
jobs- that Nis facility will create. And far more important than the profit that the company or owner will make from R.
tthinkthatin-many cases;- there are risks that maybe avoidable and there are those that are not. I belleve that the potential
risk of danger from having this facility In Eastlakeor in any family community is one that maybe avoidable. I would hate for
anyone to have to say" I knew It, I knew this would happen.'It is not hard at all to foresee the consequences and potential
for danger of having such specialty facility" In anycdmmunity or growing families with children, It Is hard to believe that they
have even considered that Iocat)on:- Please -do not subject our familles, our children to this avoidable dangers, by helping
with finding a more suitable Iocatlon for this facility.
Also If I may share. The moment my famlly'learned about this, we were all very shocked, My 12 year old daughter's reaction
was, "Mommy, you know I don't like moving but if they build the hospital I think we need to move' I wanted to share my
daughter's .reaction because I am sure that you have heard mostly from adults or parents, I think that kids know more than
what we think they do. I just think that F a 12 year old child can Immediately realize the potential risks from this facility, than
t could expect more from the City Planning Committee. Asa mother, I have taught my children to never exclude and I would
never want to add to the stigma on mental illness. It is real and it needs to be addressed, BUT I also would liketo be true to
myself, speak out my concerns and do what I can do to keep my famgy and my community safe. Again. I am not against
the building of this faclllty, but I like many would just like for Itto be built Ina place where itwould yield the least riskfor both
the patients and the people around it.
Thank you so much for hearing all our concerns
Aileen Jerre
Homeowner, Mother, Community member
Caroline Yount
Froom Patricia Salvation
Sent: Wednesday, May 22, 2019 11.04 AM
To: Caroline Young
Subject: FW; Concerns over Psychiatric Facility- eastlake
Sharing...
From: Miss M
Sent: Wednesday, May 22, 2019 7;58 AM
To: Patricia Salvation <psalvaclon@chulavMaca.gov>
Subject: Concerns over Psychiatric Facility - eastlake
Hello, I am an Eastlake resident. As I have stated before, I have a number of safety concerns that I would like
to have addressed regarding the Psychiatric Hospital Proposed for 350 Showroom PI.
Distance from Integrated Healthcare and limited accessibility; This facility will be 20 miles awayfrom Scripps Merry Hospital
In Hillcrest, far removed from much of the population it currently serves, How will patients get to this location with limited
public transportation and quick accessibility only available vla toll road?
Release Concerns and Escape Risk: What will happen to patients when they are released and refuse help from a social
worker? What happens when patients lack housing, access to additional medical care, or a family/support system to assist
them?
Proximity to Children: Increase In traffic, loitering, and homelessness create safety concerns for the many schools, parks,
.and day care centers that are In the neighborhoods immediately adjacent. How will this be addressed?
Limited Pbllce & Resources: Adding a new facilityof this scale will likely cause an Increase in call volume resulting in an
Increase in response time from ambulances, fire, and police, Chula Vista currently does not have enough police and
Eastlake has thefewest patrols assigned to handle Issues arising from the facility or from those released. CVPD has the
lowest sworn officer -to -population ratio in the county at less than 1 sworn officers per 1,000 residents. How will this be
addressed?
My understanding is that you are only required to notify people within 500ft of the site please make sure to include me in
the notification sent by the city. you may do so via email.
Concerned Resident,
Monica Nelson
Sent on my Boost Mobile Samsung Galaxy SS.
Caroline Young
From:
Patricia Salvation
sent:
Wednesday, May 22, 2019 1:58 PM
To:
Kelly Broughton; Caroline Young
subject
FW: Eastlake Psychiatric Hospital
Sharing...
----Original Message -----
Prom: Alita < _.
Sent: Wednesday, May 22, 2019 1:46 PM
To: Patricia Salvation <psalvacion@chulavistaca.gov>
Cc: montano.monica@scrippshealth.org
Subject: Eastlake Psychiatric Hospital
Warning: External Email
Hello Patricia,
I am an Eastlake resident. I have a number of safety concerns that I would like to have addressed
regarding the Psychiatric Hospital Proposed for 350 Showroom Pl.
Distance from Integrated Healthcare and limited accessibility: This facility will be 20 miles away
from Scripps Mercy Hospital in I- llerest, far removed from much of the population it currently
serves. How will patients get to this location with limited public transportation and quick
accessibility only available via toll road?
Release Concerns and Escape Risk: What will happen to patients when they are released and
refuse help from a social worker?
What happens when patients lack housing, access to additional medical care, or a family/support
system to assist them?
Proximity to Children: Increase in traffic, loitering, and homelessness create safety concerns for
the many schools, parks, and day care centers that are in the neighborhoods immediately adjacent.
How will this be addressed?
Limited Police & Resources: Adding a new facility of this scale will likely cause an increase in
call volumeresulting in an increase in response time from ambulances, fire, and police. Chula
Vista currently does not have enough police and Eastlake has the fewest patrols assigned to handle
issues arising from the facility or from those released. CVPD has the lowest sworn officer -to -
population ratio in the county at less than 1 sworn officers per 1,000 residents. How will this be
addressed?
My understanding is that you are only required to notify people within 500ft of the site please
make sure to include me in the notification sent by the city. You may do so via email.
Concerned Resident,
Alita
Sent from my Whone
2
Caroline Young
From:
Patricia Salvation
Sent
Wednesday, May 22, 2019 2:35 PM
To:
Caroline Young
Subject
FW: proposed location in the showroom area
Sharing
From: Late Abdo,
Sent: Wednesday, May 22,2019 2:30 PM .
To: Patricia Salvation <psalvackm@chulavlstaca.gov>; Kathy Broughton <kbmughton@chulavistaca.gov>;
montano.monica@scrippsheakh,org
Cc: Wila Abdo
Subject: proposed location in the showroom area
^War�iirg,
Fxidmal'; May22, 2019
�r{(511 To W hom It May Concern:
Re: Psychiatric hospital In Rolling Hills
I'm writing to you In regards of the proposed location for the psychiatric hospital from Scripps/Acadia. I'm a resident of Roiling
Hills In Chula Vista, as well I'm a marital health provider. I have concerns of the location of this proposed hospital Sea
resident but also as a provider.
I live in close proximity to the proposed location, as'a resident from the area, I'm concem due to the proximity to several
businesses geared towards children and termites. Within walking distance we have about 4 dance studios, play city, sky
-zone, ninja factory, aqua tots, floades; pride martial arts; speed circu11 and many other more businesses. We also have
-elementary schools and middle schools within walking distance from the proposed location. Asa resident I am concern due
.to the population this hospital is going to serve and about.the safety and possible risks children in this community could be
-exposed. Patients at a psychiatrichospital are usually there due to'imminenr danger to themselves or others and/or due to
- -complex psychiatric needs_ Reading about Acadia, seems is not suitable to guarantee to maintain a safe community due to
the amount of Irregularities and violations.
As a mental health provider, this Is one of the worst locations I've seen proposed for a psychiatric hospital for multiple
reasons. I often work with patients that have to be transported in a 5150 (involuntary hold) and others voluntary. When family
members -are :c intacted one of theirmajor challenge-is:their transportation, financialhardships and very little family support.
Having this hospital at a locatlon where there Is no easy a@y.transportatlon (bus, trolley) where the closest freeway access Is
a toll road could make h tltlflcult for families to get there and be able to pick up family members when getting
discharged. There's no other hospital or mental health agencies to provide the acute services nearby once the patients are
discharge. My other concern as a provIcar the early release of patients when they are not mentally stable. Very often a
patient learns what to say or not say in order.to get discharge before they are actually stable. What this means re that patients
who are nob mentally stable but refused to remain al a hospital learned to deny any thoughts/feelings or action plans to hurt
themselves or others and get released too early possessing a danger to themselves ariftr others. This is concerning due to
the proximity to many children's businesses, schools and the walking distance of a gun practice1shociing business in where
they can have easy access to guns (less than 1 mile from proposed location). My other concern as a provider and resident is
the limited police personnel that is In the east side of Chula Vista, There is no police station nearby and their presence is very
limited.
I understand the needfor such services in our county and city, however I'm asking you to really reconsider if this is the only
and best location for this proposed hospital. I'm asking you to please reconsider the relocation of this hospital and may be
considering a locallon such as the current available location on 450 4th Avenue Chula Vista, 91910. The Chula Vista Medical
Arts II is currently available with a building size of 30,580 sq. feet, 4 stories, walking distance to their awn Scripps hospital
and centrally Iodated In Chula Vista: This location is already set up as a hospitalwith easy access (2 freeways), parking,
many public transportation (buses and trolley) and dose to our police station for emergencies. Please consider this location
as an option for the relocation of the hospital.
Thank you for your time,
Laila Abdo
Caroline Young
From:
Patricia Salvacion
Sent:
Wednesday, May 22, 2019 9:06 AM
To:
Caroline Young
Subject:
FW: Eastlake Psychiatric hospital
Sharing...
From: Dan Luko - _.
Sent: Tuesday, May 21, 20198:50 PM
To: Patricia Salvaclon <psalvaclon@chulavlstaca.gov>, Kelly Broughton <kbroughton@chulavistaca.gov>
Subject: Eastlake Psychiatric hospital
Hello,
Email ? I am an Eastlake resident who lives 400 ft from the proposed location of the psychiatric hospital and I
have a number of safety concerns that I would like to have addressed.
Distance from Integrated Healthcare and limited accessibility: This facility will be 20 miles away from Scripps
Mercy Hospital in Hillcrest, 4arremoved-fro m -much -ofthe-papolatlorrit currently -serves: -How will patiems-get-m-
this location with limited public transportation and quick accesslbilfty only available via toll road?
Release Concerns and Escape Risk: What will happen to patients when they are released and refuse help from a
social worker? What happens when patients lack housing, access to additional medical care, or a family/support
system to assist them?
Pro>amity to Children: Increase in traffic, loitering, and homelessness create safety concerns for the many
schools, parks, and daycare centers that are in the neighborhoods immediately adjacent. How will this be
addressed?
Limited Police & Resources: Adding a new facility of this scale will likely cause an Increase in call volume resulting
in an increase in response time from ambulances, fire, and police. Chula Vista currently does not have enough
police and Eastlake has the fewest patrols assigned to handle issues arising from the facility or from those
released. CVPD has the lowest sworn officer -to -population ratio in the county at less than 1 sworn officers per
1,000 residents. How will this be addressed?
Concerned neighbor,
Dan Luko
Caroline Youn
From: Patricia Salvacion
Sent. Wednesday, May 22, 2019 9:07 AM
To: Kelly Broughton; Caroline Young
Subject: FW: please reconsider placement of the psychiatric facility
Sharing...
From: Miss M
Sent: Tuesday, May 21, 2019 9:25 PM
To: Patricia Salvacion <psaIvadon@chulavistaca.gov>
Subject: Re: please reconsider placement of the psychiatric facility
Biota
Good evening,
Empil ',;; I have been a resident of Chula Vista for the past 7 plus years (all 7 plus years have been spent in various
zipcodes within the Eastlake/Otay Ranch and Rolling Hill Ranch communities). Over the last 7 years, I have
seen a rise in both crimes and homelessness.
https://www.lonews.com/news/loul-news/otay-ranch-family-!Ipsetover-violent-video
htipsl/www.eoogle.com/amp/sZwwwnbcsandiegocom/n ws/loc I/CVPD-knife-robbery-otay-ranch Juvenile
498469391.html%3famo=v
httos://www gooale com/amo/s/www nbcsandie _com/news/local/Stabbine Prompts SWAT Standoff in Otav Ranch
492380771.1mml%3famo=v '
1 have personally witnessed a group of individuals opening packages (which I later learned were stolen from neighbors after
examining the empty boxes left in the shrubs) and then jumping the fence and heading towards section 8 housing; a rise In
the number of individuals begging for money and/or loitering near the W almart on Eastlake Parkway; and an increase in
tagging In residential as well as commercial areas.
Now, I'm hearing there are plans to build an inpatient psychiatric hospital in the area. I am adamantly against this[
I agree with all the concerns expressed on the petition. The current proposed location is not the place to put this
type of fa ilityl There Is very little public transportation and therefore patients will have few options once released.
In addition the proposed location is only a mile and a half from Eastlake high school, the largest high school In the
area with over 3,000 students and literally across the street from Montevalle (one of the largest parks in Chula
Vista) Eastlake middle school as well as Salt Creek Elementary (which have a combined total of over 2,500 young
children). The location is also within a mile of Thurgood Marshall elementary with over 650 kids and a mile and a
half from Arroyo Vista elementary with over 600 children for a total of almost 7,000 children within a mile and a
half radius!
Instead of focusing on increased building in the community, we should look into ways to make the current residents
safer. We need a police substation in the Eastlake/Otay Ranch area. Chula Vista police station Is located 6-11 miles
away from the Otay Ranch area which houses over 16,000 residents, and the Rolling Hills Ranch community, an
area that houses over 7,500 residents (and Is near the proposed hospital site),
Please reconsider placing the inpatient psychiatric hospital in an already saturated community and focus on the
residents and thelrfamilies by instead building a police substation east of the 805.
Thank you,
Monica Nelson
Chula Vista resident
Sent on my Boost Mobile Samsung Galaxy S8.
Caroline Young
From:
Patricia Salvaclon
Sent
Wednesday, May 22, 201911:02 AM
To:
Kelly Broughton; Caroline Young
Subject
FW: psychiatric facility in eastlake
Sharing...
Frown: MissN�
Sent: Wednesday, May 22, 2019 8A8 AM
To: Patricia Salvation <psalvacion@chulavistaca.gov>
Subject: Re: psychiatric facility in eastlake
1MarnTng
-'at 'Stmt : lam a chula vista resident and am extremely concerned with the recent application from Acadia and Scripps to
l build a 120 bed psychiatric facility In eastiake. Notonly is this proposed facility near thousands of students but
it is also in an area with little transportation and even less police presence.
All you need to do is Google Acadia healthcare news and you will see numerous Investigations, allegations, and lawsuits. Is
this the type of company you want to allow into chula vista? Isthis the type of company you want to deal with?
Acadia has a dangerous reputation and is looking to place it's facility In an area not adequately able to support it.
In an article dated April 23, 2019 regarding Acadia Montana R states:
-According to the inspection report, six residents escaped the facility by climbing over or
going "through" a fence on Sept. 11, 2018. Two of the residents returned on their own, and
four were returned by police, In addition to getting the date wrong, the facility reportedly
"did not state staff were unable to control residents. They broke through five doors inside
the facility to gain access outside. The residents then climbed the fence" and escaped."
Ina study done in 2017, it was noted that chula vista has the lowest police to population ratio in all of San Diego county.
Can weafford to place a facility like this in an area with no police presence? It isnot safe for patients and not safe for chula
vista residencel
Acadia's shady practices have lead to a multimillion dollar settlement for Medicaid fraud. Even their shareholders
have flied class action lawsuits against them.
Acadia Is a greedy for-profit company looking to Increase profit; while risking the lives of chula vista residents.
Please do not approve their request. Stand up for chula vista and its residents!
Respectfully,
Monica
Sent from Yahoo Mail on Android
Caroline Young
From:
Patricia Salvacion
Sent:
Tuesday, May 21, 2019 1:59 PM
Tw
Kelly Broughton, Caroline Young
Subject:
FW:Opposition of New Behavioral Health Facility in Chula Vista
Attachments:
Picture attached.cim
Sharing...
From: Jennifer Villa _.
Sent: Tuesday, May 21, 2019 1:12 PM
To: Patricia Salvacion <psalvacion@chulavistaw.go"
Subject: Opposition of New Behavioral Health Facility in Chula Vista
Good afternoon Patricia,
I am writing to express my concerns and objection over the planned construction of a new Behavioral Health
Hospital at Showroom Place in Chula Vista. I am part of a growing community that has gathered over 2500
signatures protestingthe build and location of the hospital.
Approval of a Behavioral Health facility at this location is not good for our neighboring community and conflicts
with Chula Vista's Visions and Themes as stated in the Master Plan.
Acadia, is reported to have g0% ownership of this new facility. Acadia has not demonstrated the proven excellence
with managing behavioral health facilities needed to earn my trust and to allow me and my family to feel safe. We
have collected dozens:of articles showing Acadia's mismanagement. The documentation we have compiled are
... filled with lawsuits, County Mental health violations, elopements, Federal Investigations, I ncident reports of death,
rape, abuses, negligence and fraud. This Is not a partner we trust and want in our community, let alone our
neighborhood. _
There are naturally risks that are associated to a community where a behavioral health facility is located, from
"elopement" and "Wandering" of patients to release policies that allow for patients to enter in to the neighboring
community. There are concerns with safety with an increase in homelessness, loitering and even possible escape
of patients who pose a threat to others. This proposed facility backs up to a neighborhood, walking paths and parks
all where children should feel safe to play and walk to neighboring schools. In the picture attached, taken from
Acadia's proposed plan, I have starred several of these areas, such as neighborhoods, walking paths, parks, schools
and businesses where children and families frequent. This is not a safe location for a behavioral health facility in
which the very nature of Its business requires 24 hour security.
The location ofthe 'proposed facility Is poorly designed in that it is situated at the end of a cul-de-sac with only a
toll road freeway as its closest route in and out of the area. This massive 120 patient facility cannot easily
accommodate the traffic from visitors, patientsand emergency responders needing to get in and out of this
location without it causing a nuisance to the neighboring community, or far worse, the ability to respond to an
emergency situation. A behavioral hospital would be better located next to more accessible modes of
transportation, away from family oriented businesses and neighborhoods and near a community that has the
supportive systems in place to accommodate outpatient care.
To round out my list of concerns are those havingto do with noise pollution and a decrease in home value. We
live in a quiet neighborhood where the only sounds we hear are those of kids laughing and playing in the
neighborhood and nearby parks. I am concemed that our neighborhood will be Inundated from the noise from the
additional traffic In to the area and the sounds of sirens as ambulance and police are transporting patients or
responding to hospital needs. In a research study in Virginia titled, "Not in My Backyard": The Effect of Substance
Abuse Treatment Centers on Property Values" it was found that a "treatment center Is associated with an B%
reduction In nearby home prices, and that this discount is magnified for treatment centers that specifically treat
opiate addiction (as much as 17%)". One could imagine what the reduction of home values would be on a home
in close proximity to a behavioral health faciiitythat not only treats substance abuse but also services patients who
are deemed a threat to others.
In conclusion, I want to point out how a proposed behavioral health hospital has elicited a strong concern with
regard safety In our community. Over 2500 neighboring community members have responded by signing the
petition against the location of a behavioral health hospital at that location for these reasons. We feel that
approval of this project would conflict with Chula Vista's Visions and Themes and land Use and Transportation
provisions that have been outlined in the Master Plan. Most specifically regarding the following:
- Theme 3i Strong arid`Safe Neighborhoods and Theme 5: Healthy and -Sustainable Community - - - -- - -
Each neighborhood in Chula Vista continues to express its individuality and character; is safe and attractive,
with good access to necessary facilities and services; and provides convenient transportation options.
Citizens feel safe to walk within and among neighborhoods and allow their children to do the same. Chula
Vista also takes a leadership and collaborative role In ensuring the safety of its citizens on a citywide and
regional level. The theme of strong and safe neighborhoods Is highlighted in several elements of this
General Plan, Including the Land Use and Transportation Element, the Housing Element and the Public
Facilities and Services Element. The theme is developed through a land use plan providing sufficient and
varied housing opportunities, and through the provision of excellent public services, Including police and
fire protection; quality schools,, and convenient parks and recreation facilities.
Land Use and Transportation Pedestrian Sidewalks, Paths and Trails
Pedestrian sidewalks, paths, and trails are important for several reasons, including: mobility and access;
connectivity between land uses; safety; health; and community Interaction. Not all people get to their
destination by automobile, including those too young to drive, the elderly, or those who prefer to walk. Even
for people who do drive or take transit, all trips begin and end by walking. Sidewalks and other pedestrian
pathways are important for providing connections to schools; parks; shopping; Jobs; and between
neighborhoods. Children, in particular, should be able to walk safely to school. Increased numbers of
people walking along streets creates a safer environment and, thereby, encourages others to walk also.
Vibrant urban areas always have high levels of pedestrians
We ask that you carefully consider our concerns and deny the application for the proposed new behavioral health
facility at this location.
Best Regards,
Jennifer Villa
References
Claire to Roche, Bennie Waller, and Scott Wantland (2014) "Not In My Backyard": The Effect of Substance Abuse
Treatment Centers on Property Values. Journal of Sustainable Real Estate: 2014, Vol. 6, No. 2, pp. 63-92.
hftp•//www iosre ora/wp-content/unloads/2014/12/9830 63 92,pd
9
ro
"Not in My Backyard":
The Effect of Substance Abuse
Treatment Centers on Property
Values
Authors Claire R. La Roche, Bennie D. Waller, and Scott A.
Wentland
Abstract Residential treatment centers offer the most intense form of treatment
for substance abuse and ate often embedded in residential
neighborhoods. As a=oil of the patient Protection and Affordable Caro
Act, the number of treatment centers has been forecasted to burgeon.
We examine the external effect of residential rehab centers on nearby
real eatme As addiction treatment centers are planted, a common
response of nearby property owners is "not in my backyard', (NIMBY).
Using a large MIS dataset from central Vulud, we estimate the impact
of substance abuse treatment centers on nearby home prices and
liquidity (as measured by time on market). We find that a neighboring
-treatment water is associated with an g'% reduction in nearby home
prices, and that this discount is magnified for treatment centers that
specifically treat opiate addiction (as much as 17'%).
. The. primary .residence is perhaps the greatest single investment made by an
-individual and the.mantra `location, location, location" is an evenpresent concern
of a prospective buyer. Before purchasing a home, a savvy buyer will frequently
research the community and the school system, as well an the crime statistics.
Whet homeowners are made aware of an application for a special use permit
for the possibility of an addiction treatment center being located in their
neighborhood, initial concern for personal and household safety, followed by the
stark realization that home values in their neighborhood may be adversely affected,
almost always lead homeowners to the universal response of "not in my backyard"
(NRABY). The typical opposition to a proposed substance abuse treatment facility
is based on two visceral concems: an increase in crime risk and a related decrease
in property values. The primary purpose of this paper is to examine the latter
claim empirically, determining whether there is significant evidence that treatment
centers have a negative impact on nearby real estate.
Ex ante, it is not clear that substance abuse treatment centers will adversely impact
neighboringreal estate, which motivates our empirical examination of this
externality. On one hand, there may be a priori reasons to suspect that treatment
facilities will not have much of an impact on neighboring real estate. Locating
r addiction treatment centers in residential areas has become commonplace.
JOSRE I Voi. 6 1 No. 1 -1014
64 1 to Roche, Waller, and Wenfland
Treatment centers tend to be inconspicuous and may have blackout curtains and
minimal signage (or no sign). The housing is often gated and locked at a certain
time of the day. Generally, clients enrolled in residential treatment programs are
not allowed to interact with the "locals" of the neighborhood or leave the
premises. Under current law (discussed in the next section), despite their
challenges, residential treatment centers have relatively few limitations on where
they are sited.
On the other band, like many negative externalities or NIMBY issues, there are
reasons to suspect that rehab facilities may adversely impact neighboring real
estate. Substance abuse is a multifaceted health issue and many patients in
residential treatment have a dual diagnosis: a mental health issue and An addiction
(Connery, 2011). The Substance Abuse Mental Health Services Administration
(SAMHSA, 2008) surveyed 14,423 facilities in 2008 and had a response rate of
94.1%. The SAMHSA survey indicated that 39% of the clients in treatment centers
had a dual diagnosis. In addition, concurrent alcohol and dmg addiction accounted
for approximately 45%, while clients in treatment solely for drug abuse accounted
for 34%-36% and 18%-20% of the padems only abused alcohol (SAMHSA,
One consequence of locating drug and alcohol rehabilitation centers in residential
areas is that patients in substance abuse treatment programs frequently leave or
areadministratively discharged before successful completion. At some point,
experts say that, "relapse is an almost unavoidable—and potentially useful—step
in recovery" (Shaffer, 2012). For many, intensive residential treatment is a "last
resort." A healthy family of an addict will decline to "enable" negative behavior
_
and, instead, will Insist that the alcoholic/addict experience the "consequence"
of the decision to use Again and refuse treatment. In other words, the family Will
often net offer any form of financial support and the addict will have to fend for
himself or herself. in addition to having a substance abuse disorder and possibly
a dual diagnosis, those who relapse and leave treatment prior to completion often
have limited job skills and perhaps even a criminal record—factors that make
employment a chAllengo. Thus, as a practical matter, nearby neighbors may have
valid concerns that the presence of a treatment center will be accompanied by
additional unemployed or even homeless addicts on the street near the area in
which the treatment center is located. This perception of elevated risk in these
Areas maythen be reflected in the market prices of nearby real estate.
The likely oocurtence of relapse combined with the probability of criminal charges
and/or convictions associated with substance abusecorroborates the Argument that
the presence of a treatment center may bring objectionable consequences into a
community. The purpose of this .paper is to use market data to assess whether
there is substantial evidence of nearby real estate being adversely impacted by the
presence of treatment centers, consistent with the potential risks that proximity to
these facilities may bring. As a clear-cut NIMBY issue, this paper contributes to
the broader literature of examining the market effects of specific externalities or
_ enviromnental factors in real estate. Our study contributes to the literature by being
the fist to examine the effect of substance abuse treatment centers on the
"Nef in My'Baekyord" 165
surrounding real estate market and, more generally, adding to our understanding
of external factors that impact home prices.
Substance Abuse Treatment: Salient Issues,
Recent Trends, and Related Literature
It is anticipated that the impact of the July 1, 2014 changes to insurance coverage
under the Affordable Care Act (ACA) will cause the number of treatment centers
to burgeon and thus, a study of the effect of nearby addiction treatment centers
on real estate is timely. Prior to investigating treatment centers' effects on nearby
real estate, it is crucial to understand the background of substance abuse treatment
and why the current issues motivate the examination of potential real estate
externalities.
Although accurate statistics of drug or alcohol disorders are difficult to obtain,
according to a Harvard Medical School Special Health Report, between I"o and
28% of Americans will have a substance use disorder sometime during their
lifetime and this estimate does not include addiction to nicotine (Shaffer, 2012).
Residential treatment has become a more common way to treat addiction and, like
many areas in healthcare services, residential rehabilitation has become a growth
industry.
Broadly speaking, there are three types of treatment centers: intensive outpatient
Program (fOP),inpatient treatment, and partial hospitalization program (PUP).
Typically, IOP treatment centers offer each client nine hours of group therapy, one
hoar of individual therapy, and one hour of case management (managing auxiliary
services) per week. IOP clients either live in a halfway house or at home with
shict guidelines established by their primary therapist. Although halfway houses
can vary greatly, they generally have full-time house managers and mandatory,
random urinalysis. Inpatient programs require clients to live at the facility in which
all treatment takes place and may either be freestanding or hospital-based. PHP,
also known as the "Florida model," is a hybrid version of inpatient treatment and
intensive outpatient treatment: individuals go to a counseling center during the
- - -- '.day, and after a full day of therapy sessions return to off-site housing located in
- "_-- -- - ' a neighborhood.'Behavicral health technicians work at the off-site facilities around
the clock.
Mandatory addiction treatment (commitment) does not exist under the law. An
addict must choose to be in a recovery program. It is interesting to note that all
three of the substance abuse treatment models include the possibility of group
hoaxing in neighborhood settings.
Projected Increase, in SLID Treatment Facilities: MHPAEA and the
ACA
The Patient Protection and Affordable Care Act (PPACA), also known as Obama
Can, made sweeping changes to Mental Health/Substance Use Disorder
JOSRE I V.I. 6 1 Ne, 1 - 2014
S6 1 Lo Reehe, Wollee, and Weetle,d
(MH/SUD) insurance coverage that went into effect on July 1, 2014. To
understand the ramifications for residential treatment centers, it is necessary to
briefly examine the legislative history of MH/SUD insurunce coverage. Prior to
July 1, 2014, the high cost of MH/SUD treatment meant that it was only available
to patients with (or whose families have) considerable means, or those whose
health insurance provided coverage. The Mental Health Parity and Addiction
Equity Act of 2008 (MBPAEA) attempted to address the unequal treatment of
hiH/SUD health insmance coverage and legislated equal treatment between MH
/SUD benefits and medical/surgical benefits. If a pian had MHISUD coverage,
then it must be on par with the medical/surgical benefits offered under that policy.
The MHPAEA did not mandate that an insurance policy must cover MH/SUD
and only applied to group health plans sponsored by employers with 50 or more
employees. Both individual and small employer group policies were specifically
exempted from coverage (MHPAEA Fact Sheet).
The PPACA mandates that MH/SUD coverage be included in marketplace health
insurance policies as an "essential health benefit" as of July 1, 2014 (1vI ]PAEA
Fact Sheet), —,be effect of inclusion of MH/SUD coverage as an essential health
- - - - - - - - - - - - -benefit -is -that- the. MHISUD .parity .rales . now, apply to norr-grandfathered
individual and small group plans (Eeronio, Po, Skopec, and Glied, 2013). With
expansion of the "parity riles" and inclusion of MH/SUD coverage w an
essential health benefit under the ACA, it is anticipated that the number of patients
having access to expensive addiction treatment options will grow exponentially,
as will the number of treatment center;.
fitntidlsarimination Housing laws
When a pibposed treatment center is sited, concerned members of the community
frequently pressure lawmakers or Erre attorneys, causing treatment centers to fight
protracted legal battles that attempt to prevent the opening of the center However,
numerous laws hinder such NIMBY efforts, providing legal basis for treatment
centers to be located just about anywhere. There are several federal laws that
prohibit discrimination.in housing based on a "disability" and define disability
as: "Any person who has a physical or mental impairment that substantially limits
one m mare major life activities; has a record of such impairment; or is regarded
as having such impairment" (HUD).
Substance abuse disorders are clearly recognized disabilities and thus are covered
under fair`. housing laws. Federal housing laws that prohibit disability -based
discrimination and ensure equal housing opportunities are briefly discussed below.
Fair Housing Act. The Fair Housing Act (FHA) was designed to prohibit
discrimhtation in housing. In 1988, the FHA was amended to include persons with
handicaps to the protected classes under the FHA, 42 U.S.C. §3604(f)(3)(B). The
definition of "handicap" under the FHA is very broad, and drug addiction and
alcoholism are considered to be disabilities that we covered. The FHA also has a
provision (42 U.S.C. §3604(f)(9)) that permits the exclusion of those "whose
truancy would constitute a direct threat to the health or safety of other individuals
or ... would result in substantial physical damage to the property of others." Thus,
"Net In My Ba<kycrd" 167
the PHA does not protect an individual currently using illegal drugs or a person
with a conviction of distributing or illegally manufacturing a controlled substance.
The FHA covers almost every aspect of a real estate transaction. According to the
Act, it is illegal to discriminate in the sale or rental of a dwelling against a person
with a disability. Thus, son alcoholic/addict cannot be denied housing based solely
on his or her addiction. The Act does permit "reasonable local, State or Federal
restriction regarding the maximum number of occupants permitted to occupy a
dwelling" 42 U.S.C, §3607(6)(1). This exemption is for living space per occupant
and is intended to promote health and safety, not exclude group homes from
residential areas.
Although a person with a conviction for dealing or illegally manufacturing a
controlled substance is not protected under the FHA, a drug distribution conviction
does not automatically exclude a person from invoking the Rehabilitation Act or
the Americans with Disabilities Act.
Rehabilitation Act. §504 (45 CFR Pan 94) of the Rehabilitation Act of 1973.
prohibits any entity from receiving federal funds from discriminating on the basis
of a disability. Drug addiction and alcoholism are covered under this set as well.
Communities have attempted to use zoning laws to exclude 'treatment centers.
Under §504, if a community's zoning regulation excludes substance abuse
treatment centers, that community risks losing its federal funds.
Americans with DisabRities Act. Among other things, the purpose of Title R of
the Americans with Disabilities Act (ADA) is to eliminate discrimination in
housing against people with disabilities. This Act has further reach than §504 of
the Rehabilitation Act because the receipt of federal funds is not required for Title
H of the ADA to apply.
Zoning and Case Law. Zoning regulations create perhaps the biggest barrier to
entry, for a substance abuse center. As a practical matter, when considering a
proposed site for a treatment center, the owners prefer to avoid spending a lot of
time and money fighting a protracted court battle associated with a zoning
ordinance. This mindset, however, did not stop a significant case from being
appealed to the United States Supreme Court by Oxford House, a self-supporting,
_.-resident-nm,.residential treatment program. In the landmark case of City of
Edmonds T, 'Oxford House, Inc., or al., 514 U.S. 725 (1995), the City of Edmonds
attempted touse an occupancy restriction in a zoning ordinance to exclude
treatment centers from residential meas. The zoning ordinance in question allowed
an unlimited number of related persons to live in a home and attempted to restrict
the number of unrelated persons living in a single-family dwelling to five. The
City of Edmonds claimed that the §3607(6)(1) exemption to the PHA applied to
the city's zoning ordinance. In a 5-4 decision, the Supreme Court held that a
zoning ordinance that defined a family in such a way as to exclude treatment
centers was unlawful. The ordinance was not a maximum occupancy provision
but a provision describing who may compose a "family" and, thus, it violated the
FHA. This case was a critical victory for the "Oxford House Model" because
this community-based treatment program leases houses located in upscale
neighborhoods across the U.S.
10s RE I Vel.6I No. 1-4014
68 1 to Roche, Waller, and Wenlland
The bottom line is that there must be a "rational basis" for zoning regulation to
be valid and localities have consistently been prohibited from discriminating
against substance abuse treatment centers. Absent drastic changes to the laws
outlined above, it is clear that residential centers ere here to stay, and that if
challenged in court, NIMBY proponents will have an uphill battle. Thus, given
the growth trends in this industry, the potential risks posed to neighbors, and the
laws that protect the treatment centers' rights to locate almost anywhere, what is
the consequence 'for real estate when a treatment center is located in one's
"backyard," so to speak?
Related Literature in Real Estate
Researchers have long recognized that numerous externalities impact the
marketing outcomes of residential real estate. These externalities may include, for
example, neighboring pollution,' or even the condition of adjoining or nearby
properties and/or the tenant's behavior living in such properties. Real property
has intangible benefits or disamenities, which are determined largely by public
perception and capitalized into the pricing and marketing duration of residential
properties,+urthetmore,, negative extomalitiesare likely tosignificantly impact the.....
marketing outcomes of properties in close proximity to the properties being
marketed for sale, as well as impact the desirability of the overall neighborhood.
Such "stigma" events are likely to be correlated with an exodus of higher income
residents causing a "snowball" effect in declining property values (McCluskey
and Rausser, 2003),
There are a number of researchers who analyze the degree to which external or
neighborhood factors, both positive and negative, are capitalized in residential
'real estate marketing outcomes. For example, Thaler (1978) finds a negative
relationship between neighborhood crime rates and property values, Gibbons
- -_ _ --
(2004) finds an inverse relationship between vandalism and property values in
_-London.As one would expect, robbery and aggravated assault rates have a
significant and negative impact on property values (Ihanfeli t and Mayock, 2010).
Pope (2012) found that decrease in crime rates had a positive effect on property
values, particularly in those cities with substantial decreases in crime rates. Using
a microspatial approach, Resists (2002) examined the impact of the visual
encumbrance: ofpower lines on property value and finds that on average it
_ _.. _... negatively,impacts.value by approximately 10%, but increases to 14% in areas
where setback in property lines are less.
As a result of the recent economic and housing collapse, there are several studies
that have examined the impact of foreclosed properties. Foreclosed properties may
present a variety of negative effects on neighboring properties, including (but not
limited to) the "eyesore effect" where neighboring foreclosures that have long
been vacant adversely impact the aesthetic appeal of the neighborhood. Sucb
studies include Harding, Rosenblatt, and Yao (2009), Lin, Rosenblatt, and Yoe
(2009), Daneshvary, Clauretie, and Kader (2011), Daneshvary and Clametie
(2012), and Agarwal, Ambrose, Chomsisengphet, and Sanders (2013). Generally,
these studies find negative neighborhood spillovers from foreclosed or distressed
properties. -
'Not in My Backyard" 1 69
A review of the literature does not reveal any specific examples of residential drug
rehabilitation centers and their impact on neighboring property values. However,
there is analogous literature of undesirable neighbors impacting property values.
For example, Congdon-Hohman (2013) finds a significant and negative effect on
home values located within one-eighth of a mile of a methamphetamine lab. The
effect dissipates both as time passes after the discovery of and distance from a
meth lab. Reichert, Small, and Mohanty (1992) estimate the impact of landfills
on nearby real estate, finding a negative impact when located within several blocks
of an expensive housing area. They find an effect that ranges from 5.5% to 7.3%,
depending on the distance from the landfill. Indeed, the authors find that the
percentage impact on older, less expensive properties to be significantly less (3%-
4%) relative to the more expensive properties. Similarly, Hite, Chem, 11itzusen,
and Randall (2001) find significant differences in property values located within
3.25 miles of a landfill.
Other studies have shown that a variety of other external factors affect real estate
market outcomes. Coulson and Leichenko (2001) find that designated properties,
as well as neighboring properties, are significantly impacted by historical
designations. Other examples include the impact of registered sex offenders on
the marketing outcomes of neighboring properties. Three recent studies have
examined the impact m to the proximity of registered sex offenders. Most recently,
Wentland, Waller, and Btastow (2014) found that close proximity to sex offenders
rendered large price and liquidity effects, declining but significant out to one mile.
- The authors also found amplified effects for homes with more bedrooms, a proxy
for children, and whether the nearby offender was convicted of a violent sex
offense. -Linden and Rwkoff (2008) found significant reductions in home prices
across radii of less than 0.1 miles and 0.1 to 0.3 miles when an offender moves
in. Pope (2008) found properties located within 0,1 miles of a sex offender
significantly reduced home values.
I Data
We.use residentialreal estate data from a multiple listing service M) located
in central Virginia, including Richmond and other surrounding areas, MLS data
-. _.. ...............: are critical for any externality study, particularly those that analyze both time on
market and price, because it contains both the list date and sell date (or withdraw
date) of residential properties, while tax data and other publically available data
usually only include the property's date of sale. This is critical because nearby
amenities or disamenities may be capitalized into a home's price, liquidity, or
- - - some combination of the two. In this study, we examine both, While the expected
sign of living near a potential disainumity is likely negative for the price estimates,
the estimated impact on liquidity is theoretically ambiguous. While the disamenity
may lower the arrival rate of potential buyers, lengthening the time on market,
the seller may be willing to discount the home in part to counteract this effect.
The sample is composed of listings in the residential real estate market over
approximately a decade, between 2001 and 2011. The initial housing data contains
207,793 observations (including both sold and unsold properties). Among others,
JOBRE 1 Vol. 6 1 No. 1 — 3014
70 i to Raeho, Weller, and Wentlond
Levitt and Syverson (2008) point out that MIS data are entered by real estate
agents and can be incorrect or incomplete. The data were carefully examined in
light of common issues prevalent in the data. After culling for incomplete, missing
or illogical data that suggest data entry errors or extravagant outliers, the final
data set consists of approximately 194,983 homes on the market, with
approximately 111,580 that eventually sold.' The MLS data include numerous
property characteristics (square footage, bedrooms, baths, age, acreage, etc.) and,
of course, each property's location.
Our MLS data are a fairly representative housing market in the U.5., which
includes urban, suburban, and rural sales. Richmond is a medium-sized city
located in the eastampad of central Virginia and the MIS covers much of the
"Greater Richmond" was (or Richmond MSA). The average property in this MLS
has a listing and selling price of $263,641 and $742,116, respectively. The average
listed property was 25 years of age, with 2,143 square feet, 3.6 bedrooms, and
2.4 bathrooms with an average time on market of 85 days. During this time period,
them were 36 substance abuse treatment centers located within the broader region
encompassing the listings in our data and nine were located within the city limits
of Richmond specifically' See Exhibit 1, for additional descriptive statistics.
The primary source of the treatment center externality is its proximity to a given
home on the market Intuitively, there is likely an increasing NU1MY sentiment
as the proximity to the center is closer in distance. Thus, we compute the distance
from a given home in the MLS and each treatment center, using address data to
code the longitude and latitude from which the straight-line distance is calculated
using.the great -circle formula, While NIMBY does not literally refer to one's
"backyard," it is usually taken to mean very close proximity, but the definition of
what qualiSes as "very close proximity" may be different depending on the person
and the issue. Below we examine the effect of nearby substance abuse treatment
' centers on nearby real estate, using different spatial proximities (e.g., 0.175 miles,
- 0.15 miles, and 0.125 miles) as a robustness chec)L°
Empirical Methodology
our primary goal is to isolate the effect of a treatment center on neighborhood
real .estate. outcomes. Numerous studies have examined other neighborhood
externalities; using.a variety of empirical approaches.' Initially, we focus on a
_ _treatment center.'s_effect on the sale price and liquidity of a home, utilizing a
cross-sectional OLS hedonic pricing model as the baseline. While hedonic pricing
models are commonly used to determine the value of specific property attributes
and surrounding (dis)amenities by estimating marginal effects on the sale price of
the property,' we also explore a simultaneous equation model to account for the
joint determination of both price and liquidity. The purpose of exploring multiple
approaches is to demonstrate that the results are not particularly sensitive to the
choice of modeling technique.
Baseline OLS Nedonic Models
Beginning with a simple cross-sectional approach, we provide a baseline estimate
of the effect of a nearby substance abuse treatment center, employing a traditional
"Not in My BaekyorB" I yI
Exhibit 1 1 Summary Stautics
Variable
Mn
W. Des.
b'et Price tS)
263,641
142,300
Salo Pd. (E)
242,116
127,608
" m MarkofOo Doysl
85.45
79.99
Rehab Ceuta (Derry Va, . 1 f the hares I, aear a r Jw6 center
0,0003
0,02
(J!r 'p &d in eoch Idde), 0 otherwi,e)
Age (In Y rs)
24.99
26.16
A-ae
0.79
1.91
s9"am fed'
2,143.29
888,25
Bemoans
3.60
0,77
SAx
2.36
0,,82
Fe,e vm IDaany Vac = I if foredo m, 0 Diherwisal
0,02
0,12
Numbrof 1"i
1.83
0,65
Pool PUMW Var. — 1 if the home fvs a pod, 0 dhery iw)
0.05
- 0.23
Baswnent IDummy Vac = 1 If Ihy ho- a 6osemmt, 0 otherM.)
0.17
0.38
Short Sole (Dumpy Vor.. 1 if shots ale, 0 ahannse)
0.02
0,13
Tenant (Dummy Var.. 1 If 8 6e, a M o N Ilstirg, 0 O.03
0.16
Vc t(Dummy Voc= l if]be ,home is wwnl, 0 Other .)
0.36
0,48'
Twos
1,779,95
1,311.74
HOA Fm (Oumny Va. = I if R has HOA fees, 0 A".)
0.32 -
0.47
lr7Brg IXasib,
64,41
577.40
Cony'sWn -
582.22
1,062.08
Ebb: [..Na, and ymr fixed ef(ays wmmary slap ani8ed,
hedonic model that accounts for heterogeneous characteristics of both bomes and
their locations. We estimate the following functional forms:
SP, - rpy(X„ LOC„ Ti, TOM;) + e (1)
and
TOM, = rpp(X„ LOC„ T„ LP,) +
where SP, is a vector for property selling price) LP, is a vector for property listing
price X, is a vector of property specific ehafaeteristics,s IAC, is a vector for
location control using 21P Codes (see below), T„ the variable of interest, equals
J 0 S RB 1 Val. 6 1 Ne. 1 , 2014
72 1 to Roth., Wnller, and Wentlund
1 if a treatment center is located nearby of a given home; and is 0 otherwise,
TOM; is the time on market (in days), which the literature also calls marketing
duration or a measure of liquidity, and a is an error term that is hetcroskedas[ic-
consistent and clustered by 21P Codes -
Hedonic analysis of the housing market requires some control for spatial
heterogeneity because location itself is a key source of differences in housing
prices. The goal is to disentangle specific proximity to a treatment center from
broader location differences that explain real estate prices. Following numerous
studies in the real estate and urban economics literature, we chase ZIP Code fixed
effects to control for unobserved heterogeneity across these areas so that the
explanatory variables' effects are identified from variation within a given area (or
even in a given yew, as is the case for time fixed effects). In effect, our results
may then be interpreted as the treatment center's effect on home prices given
comparable homes within the same 21P Code, but located further away. In this
sense, we are attempting to disentangle the broader location effect from the
proximity to a treatment center by essentially comparing homes within a certain
ZIP Code. Further, we explore alterative location controls (census traits, block
- - - - - - groups, and blocks). in a. similar -vein, as well as altering the. control group itself
by confining it to narrow bands around a rehab facility. Appropriate location
controls can disentangle the negative externality effect from simply a "bad
neighborhood" or "bad part of town" effect
Simultaneous Equations Approach: System Identification
Numerous studies in real estate and urban economics model price and tune on
market in a simultaneous system (like 2SfS or 3SLS) given likely joint
- determination of these factors. A seller can always lower price to increase
liquidity, and vice versa. Yet, a homc's sale price and time on market are
- - - .'determined by virtually identical factors, Econometrleally, ads creates an
identification problem becauseif one wants to model this simultaneity with a
system of equations, then, by definition, such a system could not be identified
using identical exogenous variables, While a number of empirical studies
acknowledge this simultancity,10 7umbull and Dombrow (2006) and 7.,ahirovic,
Herbert and .Turnbull (2008) have identified a novel way of overcoming this
-- - - identification problem through their incorporation of variables that represent
....._ _.
market.conditions .from other listings on the market. Below we summarize a
solution to this identification issue, as we utilize an adapted form of this approach
to model price and liquidity in a simultaneous system. -
Following Krainer's (2001) search market model, one can model a home's
expected liquidity, E[TOM], (measured as a home's marketing duration or time
on market) and expected house sale price, E[SP], as simultaneously determined
and implicitly defined as:
F(E[SPI, E[TOM], T, X, LOC, C) = 0, (3)
"Nof in My aagkyerd" 1 73
where T is an indicator of whether a home is near a rehab treatment center, X
is a vector of house (and market) characteristics, LOC is location controls, and
C are neighborhood market conditions. The latter variable, C, represents
neighborhood market conditions that have an ambiguous atemal effect on loco]
properties. On one hand, when the number of nearby homes that go on the market
increases, the supply of additional homes on the market ought to negatively impact
the price and liquidity of a nearby home (i.e., "a competition effect"). On the
other hand, the increased traffic generated from additional nearby homes on the
market could actually positively impact a home's price and liquidity, which is
termed "a shoppingexternality effect." Empirically, the sales price and time on
market can be represented as separate functions with jointly distributed stochastic
errors er and ar: -
SP = %(TOM, T, LOC, X, C) + er (4)
and
TOM = saASP, T, LOC, X, C) + ar. (5)
The vector C (i.e., market conditions or neighborhood competition) and another
-.vector, L (i.e„ listing density), are the keys to Tumbun and Dombrow's (2006)
solution to over -identifying this system of equations (since equations 3 and 4 are
not yet identified). Neighborhood competition, C, is a measure that accounts for
"nearby houses for sale as long as each competing listed house overlaps with the
period that this house is on the market, inversely weighted by the distance between
the houses to reflect the assumption that nearby houses will have stronger effects
on the sale of this house than houses that are farther away" (Zahirovic-Herbert
and Tumbull, 2008). tt Listing density, L, is similarly defined as "the measure
of competing overlapping listings per day on the market" (Zabirovic-Herbert
- ' and Turnbull, 2008), where: L(i) = Py(1 — D(i, j))a(min[s(i), s(j)] — mm[p),
l(j)]]Is(i).— l(i) + 1. Essentially, both measures capture neighborhood market
conditions by quantifying the marketing overlap of nearby homes on the market
simultaneously, however, lisfing density is weighted by time on market. Turnbull
and Dombrow (2006) point out that a change in competition while holding selling
time constant is also the partial derivative with respect to listing density (and it
is easy to see that d(p,18C = 4,M). Therefore, we can rewrite our system of
equations to reflect:
SP = wr(TOM,'T, LOC, X, L)' + er (6)
JOSRE I Vol. 6 1 Ne. t - 2014
74 1 Lo Roche, Waller, and Wentland
and
TOM = rpr(SP, T, LOC, X, C) + Er. (7)
Both L and C vectors uniquely identify the simultaneous system. Further, we
supplement this approach by using different location controls across equations.'
We estimate the system of equations (5) and (6) using three stage least squares
(3SLS) in the next section to generate a coefficient estimate of the effect of a
nearby treatment center on price and time on market. We model simultaneity using
a 3SLS approach because it incorporates an additional step with seemingly
unrelated regression (SUR) estimation to control for correlations between error
terms 13
Alternative Specifications and Robustness
While the baseline results include location controls, an additional way to isolate
the treamient_effecLof a tell* facilityjs,.by limiting the control group to homes _
closer to rehab facilities more generally (i.e., omitting observations sufficiently far
from any rehab facility). Methodologically, the comparison is then between homes
that are near a rehab treatment facility and homes just outside a given range.
Specifically, we explore the effect of a rehab center (within 1/8 toile) on nearby
teal estate as compered tosimilar homes further out (i.e., within 1.5 miles, I mile,
and 2/3 mile, respectively), TUs approach allows us to further homogenize
location as a robustness check, and to provide additional evidence that the external
offect is specific to the rehab facility, and not simply the part of town in which it
Is located.
We also examine whether facilities that only treat opiate addicts (commonly
known as methadone clinics) have a larger impact on nearby real estate. Clinics
that treat heroin or prescription addicts, for example, often use buprenorphine or
methadone as part of the rehabilitation process. Nearby residents may perceive
patients who ore still intoxicated, albeit at a lower dose, as an elevated crime risk.
Approximately half of the 36 treatment centers in our sample only treat opiate
addiction (hereinafter referred to as methadone clinics). We examine whether
nedby real estate is more affected by methadone clinics specifically.
Results
Baseline OLS Results
The baseline OLS results provide evidence that nearby treatment centers adversely
impact surrounding home values, but have little if any impact on property liquidity.
Estimating equations (1) and (2), Exhibit 2 shows that this adverse effect is not
qualitatively sensitive to the choice of the definition of "nearby." Column I shows
that the presence of a rehab center within 0.125 (1/8) miles is associated with
"NOJ in My B.,kyord" 1 75
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"Not in Mr Back7ard" 1 77
approximately an 8% reduction in home values. The corresponding impact on
time on market is not statistically signAcam at any conventional level, providing
initial evidence that the externality is primarily capitalized into home prices, rather
than liquidity. Indeed, columns 2 and 3 show that homes sold for approximately
6% or 5% less if they were located within 0.15 miles or 0.175 miles of a rehab
center, respectively. While qualitatively similar, these coefficient estimates also
provide some evidence that the externality may be diminishing in distance, as
additional, further properties are included in the latter estimates. The regressions
tabulated in columns 5 and 6 tell approximately the same story as column 4, in
that there is little evidence that rehab centers have a statistically significant impact
on a home's liquidity.
The real estate literature has not adopted a single way to control for spatial
heterogeneity. In Exhibit 3 we examine a few common alternatives, to controlling
for location. The initial estimates in Exhibit 2 use Zip Codes to control for spatial
heterogeneity. In Exhibit 3, we use census tract fixed effects (columns 1 and 4),
block group fixed effect (columns 2 and 5), and block fixed effects (columns 3
and 6). Census tracts, according to the U.S, Census,, are "small, relatively
permanent statistical subdivisions of a county ... designed to be homogenous with
respect to population characteristics, economic status, and living conditions.11t4
Census block groups are subsets of census tracts; and blocks are further subsets
of block groups. One can think of these as different measures of "neighborhoods,"
broadly to more narrowly deemed. The results from the price regressions in Exhibit
3 are consistent. with Exhibit 2, falling within a fraction of a percentage point of
one another, with an effect of approximately 7.2% to 7.9%. Columns 4-6 in
Exhibit 3 also show that substance abuse treatment centers are not associated with
a. statistically significant impact on nearby property liquidity. Overall, it is clear
that the estimates of the effect of a substance abuse treatment center on nearby
real estate is not particularly sensitive to the choice of location controls, providing
evidence that the external effect of substance abuse treatment centers is robust.
Simultaneous Equation Results
When price and time on market are modeled within a simultaneous 35LS system
- - _ of equations, the estimated effect of a nearby substance abuse treatment center on
- home- price and liquidity are similar to the OLS results, finding that nearby
substance abuse treatment centers are associated with an approximately 8% drop
in home values (within 1/8 mile). Column 1 in Exhibit 4 displays this result. Like
the initial OLS results, the 3SLS estimations also show that substance abuse
treatment centers have little impact on nearby property liquidity, as the externality
appears to be capitalized into price exclusively. Exhibit 4 provides additional
evidence that the external impact of substance abuse treatment centers is robust
to multiple modeling approaches that are common in empirical real estate studies.
Exhibit 4 also provides evidence that not all substance abuse treatment centers
may be perceived by nearby residents as presenting equal risk. It is possible that
methadone clinics have a greater NIMBY sentiment from the broader community.
We test this proposition empirically by exclusively examining the effect of
JOSgp I Vol. 6 1 No. 1 - 2014
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80 I La Roahe, Wallet, and Wantland
Exhibit 4 I Effect o4 a Nearby Rehab and Meihadane Treatment Center on a Home`s Price and
Liquidity
Dependent Dependent.
Depadad
Depedeet
Variable: w",
V.H"
Variable:
LS'sede Prim) k4Da" on M -W
IalSale Price)
WDryr on Markel)
(1) (2)
{3)
(4)
Rehab Caner <I1 8MIk -0.07^' -0.009
(-2.44) (-0.04)
Meth, Gula,<_ 118 MIk
-0,174"
0.192
1-2.35)
10.33)
I,gA,ooFR.)
-0.053•"
0.125••'
-0.063••'
0.125•"
I-118.931
(10.89)
(-118.92)
110.861
Acmago
0.019•"
0.026"•
0,019"•
0,027•"
(42.371
15.221
142.38)
(5.241
Sp. k
0.000•••
-0.000••'
0.000"•
-0.000'•'
.... ..... ...... .. .. . .. .. ... _
(232.99)....
(-7.141 . _ _
_ _ (233.00)- . .....1-7,1
Q)..
Bttiroornr
-0.023"'
0.098'•'
-0.023 ...
0,093••'
_
(-2353)
111.701
(-23.52)
IT 1.691
ealhroma
0A24'-
-0.054•"
0.024•"
-0.053'•'
122.80)
1-5.751
(22.80)
.1-5.73)
Fpeakn;.e.
-0.153'•'
-0.025
-0.1531-•
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(-0.621
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Tax. 131
0.000 ...
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(1.86)
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Not in My Backyard" I 81
Exhibit 4 1 congnuedl
Elfecf of n Neorby Rahab and Methadone Treatment Center on a Home's Price and liquidity
Dapmcl ro Dependent Dependent Dependent
W.1ble; Varia66; Vada66:_ Variable:
Insole Price) triDaya an Menial ksola Mo.) INDays at Markel
(1) (2) (3) (4)
vaiing Der O.000"' 0.000•••
121.93) (21.95)
CmtpaMion 0.000••• 0.000•••
(21.48) (21.50)
Location Centrals ✓ ✓ ✓ ✓
Year Rxed Effects ✓ ✓ ✓ J
Natc: This m61e presents the results d 6 -dank 3SIS modals afowing the effed of a .4 (I.e., within
-0.125 mile) rehab focillty, and a rehab hality that keds m 4 edone mWidw spaiflah,, on a pmpervs
m6 price and Erne on married; can leer! Anita d hen for brevity Z-dofis6cs we in porontieses. The number
d a6s®veeiom in ealeram 1-4 it 110,361.
' Sign7'icant al dna 10% W.
"SITIRaoet at the 5% Ind.
"' Significant at the 1% level.
methadone clinics. Columns 3 and 4 in Exhibit 4 display the results of the same
3SLS estimations as columns 1 and 2, but confining the treatment variable to a
..... dummy variable that equals one if the home is within 0.125 mile of amethadone
clinic: The coefficient estimates in Exhibit 4 indicate that homes within 0.125
.._.miles of -_a methadone clinic sell for approximately a 17% discount relative to
.. .. homes that are located further away, holding other factors constant. There is little
evidence, however, that these clinics affect nearby home liquidity. Overall, Exhibit
4 provides evidence that the market differentiates among risks generated by these
potential externalities, and the treatment centers that may be perceived as having
a higher risk to their neighbors have a much greater impact on the surrounding
real estate market.
As a robustness check, in Exhibit 5 we explore the extent to which the control
groups matter, finding results generally consistent with those in Exhibit 4. A
critique of hedonic models for estimating any externality might be that the
_. interpretation of the dummy variable essentially defines the control group as
bones not located now (within 0.125 miles) the potential externality. Defining the
control group in this way may present some unobserved spatial heterogeneity
issues. To address this issue, in Exhibits 5 and 6 we estimate the same regressions
as Exhibit 4, but confine the sample to homes that we located within 1.5 miles,
1 mile, and 0.6 miles of a rehab facility respectively. The results are consistent
with the initial 3SIS estimates in Exhibit 4, and by extension, the initial OLS
estimates in Exhibits 2 and 3. Both exhibits show that homes new substance abuse
JOSRE I Vol. 6 1 No. 1 - 2014
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"Not weBackyard- a,
88 1 La Roche, Wolter, and Wentland
treatment centers are still negatively impacted, and by approximately the same
magnitudes. Indeed, the last two columns are particularly striking. Given that this
is already a "within neighborhood" estimation, by controlling for location, the
fact that the substance abuse treatment center result is robust when the control
group is reduced to 1 mile and 0.6 miles indicates that unobserved spatial
heterogeneity is not likely driving the core results of this paper. More intuitively,
this provides strong evidence that the substance abuse treatment center effect is
not simply h "bad pan of town effect," in that we are comparing "apples with
apples" across the dimension of location; and, the principle characteristic
distinguishing the variation in prices in these areas is the presence of a nearby
substance abuse treatment center. Based on these results, we cannot conclude that
there is a robust impact on property liquidity, but there appears to be a robust
negative relationship between the presence of a substance abuse treatment center
and nearby home values.
_ Conclusion
- - - - - - - - - - - In this study, -we -find evidence that residential substance abuse treatment -centers -
adversely impact the price of neighboring homes. We find that homes within 1/8
mile of a treatment center sell for approximately 8% less than otherwise
comparable homes that are located further away. Furthermore, we find that the
market differentiates between potential risks that nearby treatment centers may
carry, as living new a methadone clinic that treats opiate addictions such as heroin
or morphine may be associated with a reduction in home values by as much as
17%. We find little evidence that nearby treatment centers affect a home's time
on market.
Examming this particular externality is important to the broader literature on
neighborhood externalities and environmental factors, as well as the specific
literature on the issue of residential treatment centers. The PPACA has expanded
MH/SUD coverage and made intensive treatment options affordable, and as a
result, demand for effective substance abuse treatment is increasing. Operating a
treatment center is a growing industry and it is reasonable to assume that new
centers will .be built nationally, many of which will be sited near or within
.. .residential coinmubities. Indeed, there is very little that individuals and localities
can do to prohibit a substance abuse treatment center from locating in a residential
area because alcohol and drug addiction is considered to be a handicap and thus
alcoholic/addicts in recovery are members of a protected class under the federal
antidiscrimination housing laws. Hence, as residential treatment centers become
more common, it is important to understand all their effects, including the effects
they may. have on nearby real estate and how markets price the potential risk of
nearby externalities.
Endnotes
' For a more complete review on the impact of environmental externalities, see Boyle and
Kiel (2001),
"Not in My Backyard" 1 89
' Consistent with other real estate studies, we culled outliers from our data set, confining
our data to more "typical" range of homes listed at less than $1,000,000, fewer than
10 bedrooms, fewer than 16 acres (99% of observations), property taxes paid that were
less $10,OD0 (99% of observations), and younger than 150 years old (99% of
observadons). For our other dependent variable of interes4 time on market, we similarly
trim the 1% extremes: Generally, the findings are not sensitive to dropping these
observations. Further, important to disclose how our data has been trimmed for
transparency and repficability. As an additional quality check, a sample of the MLS data
was compared in county tax records, which contain data on price and housing
characteristics.
' There were approximately 153, 96, and 60 properties listed within 0.175 miles, 0.15
miles, and 0.125 miles of a rehab treatment facility respectively, over the time period
of our study. Given the very recent and projected growth of rehab centers nationally,
future research will be able to take advantage of additional homes (data points) being
bought and sold near rehab facilities.
4 The cboice of this radius does not fundamentally alter the qualitative conclusions of this
study. The definition of one's "backyard" Is somewhat ambiguous, and may differ
depending on an individual's perception, Some externality studies use 0.1 mile, 0.2 mile,
or 0.3 mile as a radius to examine a given extemality. While similar results are obtained
looking at bands slightly larger and slightly smaller, we follow Congdon-Holumm (2013)
and use 1/8 mile in most of our tabulated regression results. An easy way to think of
0.125 miles, 0.15 miles, and 0.175 miles is that these are 2.5 minute, 3 minute, and 3.5
minute walks respectively (assuming a pace of 3 miles per hour).
'
Per recent examples of amenity or disamenity studies of externality effects, sce Asabem
and Huffman (1991), Gibbons (2004), linden and Rockoff (2008), Pope (2008), Rossi -
Harsher& Sarte, and Owens (2010), Camped], Giglio, and Pathek (2011), Hoon, Wiser,
Cappers, Thayer, and Sethi (2011), Dauesbvary, Chmectio, and Kador (2011), Grout,
Jaeger, and Plantings (2011), Daneshvary and Clamefie (2012), Congdon-Hohmon
(2013), Gulgnet'(2013), Her (2013), Montisku, Snmam, Slade, and 7hrabull (2013),
and Wantland, Waller, and Bristow (2014).
6 Recent examples include neighborhood foreclosure effects (Harding, Rosenblatt, and
Yao, 2009; Lion Roa rablatt, and You, 2009; Agarwal, Ambrose, Chomsisangphet, and
Sanders, 201 D).
7 Ruminoff, Parmeter, and Pope (2010) survey 69 bedonkc studies and found that 80%
rely on I nraq send -log, or log -log functional form. We have explored a number of non-
linear functional forms and our results remain robust. Rather than repeat all of the above
- models with various non-linear explanatory variables, the authors will produce results
of alternative specifications upon request;
I For example, we use the following property specific variables: square footage, age,
acreage, number of bedrooms, bathrooms, number of stories, new, vacant, HOA fees,
whether it has a pool, a tenant, a basement, and whether it is a short sale or foreclosure.
We also include year fixed effects to control for variation over time.
s When we explore different location controls later, we will cluster by location (e.g.,
census tract, block group, or black).
10 For example, gee Vaves and Yang (1995), Knight (2002), and Turnbull and Dombrow
(2006).
" Specifically, both our paper and Zabirovie-Herbert and Turnbull (2008) calculate C in
the following way; "The days -on -market or selling time is s(i) — 7(Q + 1, where I(0
and sib are the listing date and sales date for house i. Denoting the listing date and
J088E I Vol. 6 1 No. 1 - 2014
90 1 la Rerhe, Waller, and Wentland
sales data for house j by I(J) and s(j), the overlapping time on the market for these two
houses is min[s(i), s(j)] - max[I(t), l(j)]. The straight-line distance in miles between
houses I and j is DO, j). The measured competition for hoose i is: CM = Y, (1 - D(i,
j)J=(min[s(i), s(j)] - max[I(I), I(j)]] where the summation is taken over all competing
houses j, that is, houses for sale within one mile and 20% larger or smaller in living
mea of house Y' (Zaldrovic-Herbert and 1Umbuli, 2008).
" At the suggestion of a reviewer, we also identify the system by using different control
variables. A simple way to do this is to use different location controls. We use ZIP Code
fixed effects in the price equation, and census tract fixed effects in the time on market
equation. Generally, the results are not very sensitive to which location controls are used
in each equation. Further, the results sm, similar when we use the Tumbull and Dombrow
(2006) method alone to identify the system
" According to Bdsley (1988), when there are strong interrelations among enor terms,
3SLS is used instead of 2SL9 in estimating systems of equations because it is more
efficient. Specifically, one world expect unobsermbles that contribute to error in
estimating price to be also camelaled the error in liquidity.
11 See w,w.ocn5m.gov for more demi!, specifically: http://w .cemus.gDv/geo/www/
cob/tr_metadala.ht idigad.
I Re le rent es
Agarwal, S., B. Ambrose, S. Chomsisengphet, and A.B. Sanders. Thy Neighbor's
Mortgage: Does Living in a Subprime Neighborhood Affect One's Probability of Default?
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Ambere, E and F. Huffman. Historic Districts and Land Values. Journal of Real Estate
Research, 1991, 6:1, 1-8.
Augusta Chronicle.. Neighbors Oppose Upscale Rehab Facility in South Augusta. hnp://
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south-augusta, August 5, 2013.
Belsley, D.A. Two- or Three -stage Least Squams? Computational Economics, 1988, 1, 21-
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Bemnio, 8:., R. Po, L. Skopec, and S. Glied. ASPE Research Brief. Affordable Care Act
VAR Expand Memml Health and Substance Use Disorder Benefits and Parity Protections
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cfm, Febnmry 20, 2013.
Boyle, M. and . Hid. A Survey of House Price Hedonic Studies of the Impact of
Environmental Exteranlitiea. Journal of Real Estate Utemture, 2001, 9:2, 117-44.
Campbell, J.Y., S. Giglio, and P. Pathak. Forced Sales and House Prices. American
Economic Review, 2011, 101:5, 2108-31.
City of Edmonds v. Oxford House, Inc., et al., 514 U.S. 725, 1995.
Congdon-Hohman, 1. 'the Lasting Effects of Crime: The Relationship of Discovered
Methamphetamine Laboratories and Home Values. Regional Science and Urban
Economics, 2013, 43:1, 31-41,
Connery, H. Alcohol Use and Abuse—A Harvard Medical School Special Health Report.
2011. Fact Sheet MIIPABA. bhp://www.dol.gov/ebsa/newsroom/fsmhpaeaLtml. HUD
Disability Rights in Housing. http://porWIadgov/hudpodal/HUD?sx-/program_
offices/fair_hogsing_equal_opp/disabilities /inlwusing.
"Not in My Backyard" 1 91
Coulson, N.E. and R.M. Leichenko. The Internal and External Impact of Historical
Designation on Property Values. Joumo[ of Real Estate Finance and Econamirs, 2001, 23:
1, 113-24,
Dsneshvary, N. and T.M. Clauretie. Toxic Neighbors: Foreclosures and Short -Sales
Spillover Effects from the Current Housing -Market Crash, Economic Inquiry, 2012, 50:1,
217-31.
Daneshvery, N., T.M. Cleurede, and A. Kader. Short -Term Own -Price and Spillover Effects
of Distressed Residential Properties: The Case of a Housing Crash. Journal of Real Estate
Research, 2011, 33:2.179-2017.
Gibbons, S. The Cost of Urban Property Crime. Economic Journal, 2004, 114, 441-63.
Grout, C.A., W.K. Jaeger, and A.J. Plantings. Land -use Regulations and Property Values
in Portland, Oregon: A Regression Discontinuity Design Approach. Regional,Science and
Urban Economics, 2011, 482, 98-107.
Guignet, D. What Do Property Wass Really Tell Us? A Hedomc Study of Underground
Storage Tanks. Land Economics, 2013, 89:2, 211-26.
Harding, J.P., E. Rosenblatt, and V.W. Yao. The Contagion Effect of Foreclosed Properties.
Journal of Urban Economics, 2009, 66:3,164-78..
Hite, D., W, Chem, F. Hitzusm, and A. Randall, Property -Value impacts of an
Eavironmental Disameaity: The Case of Landfills. Journal of Real Estate Finance and
Economics, 2001, 22, 185-202,
Hoen, B., R. Wiser, P. Cappers, hA Thayer, and G. Sethi. Wind Energy Facilities and
Residential Properties: The Effect of Proximity and View on Was prices. Journal of Real
Estate Research, 2011, 33:3, 279-316.
Ihlanfeldt, K and T. Mayock. Panel Data Estimates of the Effects of Different Types of
Crime on Housing Prices. Regional Science and Urban Economics, 2010, 40, 161-72.
Knight, J. Listing Price, Time on Market and Ultimate Selling Price: Causes and Effects
.. ..of Listing Price Changes. Real Estate Economics, 2002, 30:2, 213-37.
Kramer, J. A Theory of Liquidity in Residential Real Estate Markets, Jmrrnal of Urban
Economics, 2001, 49:1, 32-53,
Kuminoff, N.V., C.F. Perimeter, Rod J.C. Pope, Which Hedomc Models Can We Trust to
Recover the Marginal Willingness to Pay for E.nvimnmental Amenities? Journal of
Environmental Economics and Management, 2010, 60:3, 145-60.
Levitt, S.D. sal C. Syverson, Market Distortions When, Agents Are Better Informed: The
Value of Information in Real Estate Transactions. Review of Economics and Statistics, 2008,
90:4, 599-611.
-.:Lin, Z., E. Rosenblatt, and V.W, Yen, Spillover Effects of Foreclosures on Neighborhood
Property Values. Journal of Real Estate Finance and Economics, 2009, 38:3, 387-407.
Linden, L. and J.E. Rockoff. Estimates of the Impact of Crime Risk on Property Values
from Megan's Law. American Economic Review, 2008, 98:3, 1103-27.
Linn, J. The Effect of Voluntary Browafields Programs on Nearby Property Values:
Evidence from Illinois. Journal of Urban Economics, 2013, 78, 1-18,
McCloskey, J. and G. Ramses. Stigmatized Asset Value: Is it Temporary or Long -Term?
Review of Economics and Statistics, 2003, 85:2, 276-85.
Munneke, HJ., C.F. Sirmens, B.A. Slade, and G. TLmbull. Housing Regulation,
Externalities, and Residential Property Prices. Real Estate Economics, 2013, 41:3, 422-56.
Pope, D. and J. Pape. Crime and Property Values: Evidence from the 1990s Crime Drop.
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Values. Jou mal of Real Estate Research, 1992, 7:3, 297-314,
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Approach to impact Measurement Joumal of Rea! Estate Research, 2002, 23:3, 275-301.
Rossi-Hansberg, E., P -D. Sarte, and R. Owens. Housing Externalities. Journal of Political
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SAMHSA. National Survey on Substance Abuse Treatment Services (N-SSATS). M.
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aspic.
Shaffer, H.-Overcundng Addiction Paths Toward Recovery—A Harvard Medical School
Special Health Report, 2012.
Thaler, R. A Note on the Value of Crime Control: Evidence from the Property Markel
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Pram the Housing Market Journal of Reel Estate Finance and Economics, 2006, 32:4,
_ 39.1-408...
Wendand, S., B. Waller, and R. Bristow. Estimating the Effect of Crime Risk on Property
Values and Time on Market: Evidence from Megan's Law in Virginia. Real Estate
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7,hirovie-Herbert; V. and G. Turnbull. School Quality, House Prices, and Liquidity. Jountal
of Red Estate Finance and Economics, 2008, 37,113-3D.
Caroline Youn
From:
Patricia Salvacion
Sent
Monday, May 20, 20191:51 PM -
To:
Kelly Broughton; Caroline Young
Subject:
FW; Major concern
Sharing.,.
From: Elizabeth Stellin
Sent: Monday, May 20,2019 1:21 PM
To: Patricia Salvaclon <psalvacion@chulavistaca.gov>
Subject: Major concern
Waiving:
External Patricia,
Ema_II
I am a resident of Rolling Hills Ranch. I live approximately one -hundred yards away from Showroom
Place, the proposed location for a new psychiatric hospital. I am just one of many local residents who
have Teamed of the proposed building of this facility. Our community is extremely concerned regarding
the building of this hospital. Our community is comprised of Journalists, paramedics, police officers,
firefighters, teachers, nurses, and lawyers, all.actively involved in fighting the construction of this facility,
many of whom have first hand knowledge of the impact these facilities can have on a neighborhood. The
overwhelmingly majority of community members I have spoken with are highly against the building of
this facility. Our online petition has received over 2500 signatures. Our efforts have attracted the
attention of local television, radio, and newspaper. _
We are not tyrants, or anti -mental health. We are a simple collection of families who moved into this
area with the idea that massive hospitals such as this were NOT in our backyards; that our children
could play safely on their streets and in their parks. The primary partner, Acadia Healthcare, has a
laundry list of complaints against them, and have been involved in some extremely concerning lawsuits.
This is not the type of company our community would trust to be associated with a 120 bed psychiatric
facility. The facility is being built directly in the middle of our neighborhood, a few feet away from a
community park, a school bus stop, multiple schools, and businesses that cater to young families and
children, Our backyards, where our children play are located less than 100 yards from the proposed site,
We have done a walk through of the businesses in Showroom Place, and have been in contact with
owners, and regional managers of the businesses and churches located in that area. Every single
person we spoke to has expressed deep concern over the location of this facility and many have vowed
to move their businesses if this facility is.bullt in the proposed location.. They have become active
members In our fight. Our numbers continue to grow daily.
The irrespohsible partnership with Acadia Healthcare is something that our community can not tolerate,
The proximity of Showroom Place to our neighborhood and local businesses is extremely unsettling to
our community members and local business owners. There are other available locations, some outside
of Chula Vista altogether. Nathan Fletcher has even proposed a location at 4307 Third Ave in the
Hillcrest area (a county owned property that is within close proximity to USC San Diego Medical Center)
that is slated to become luxury condominiums. A company such as Acadia, who has a long history of
patient elopement, safety violations, law suits, allegations of rape, sexual misconduct, child
endangerment, fraud, elder abuse, and patient death does not seem like the type of company we want
in the middle of our neighborhood, directly next to where our children play. The history of this company,
and the potential dangers a psychiatric hospital could pose to our community will be brought to light, and
is a primary focus of this community. The history of this company is well documented, and it doesn't take
much research to identify that this company is dangerous for our community.
We will be attending city council meetings, city planning commission meetings, doing neighborhood
walks, and distobuting informational fliers to all of Rolling Hills Ranch and Eastlake. We are an active,
educated, and extremely organized movement. We have made tremendous progress over the past three
weeks and as our movement grows we will only become stronger. We are asking for your assistance in
preventing the building of this hospital on its currently proposed location. Your participation In this
movement, and any assistance that you could give us would be greatly appreciated.
I look forward to seeing you at the next few city planning commission meetings.
Thank you,
Elizabeth Stellin
Caroline Youn
Prom:
Patricia Salvacion
Sent:
Monday, May 20, 201910:41 AM
To:
Kelly Broughton
Cc:
Caroline Young
Subject:
FW: No to Psychiatric Hospital in Eastlake
Shoring...
From: M A
Sent: Monday, May 20,201910:28 AM
To: Patricia Salvacion <psaIvadon@chulavistaca.gov>; Patricia Salvacion apsalvacion@chulavistaca.gov>; Kelly Broughton
<kbroughton@chulavistaca.gov>; Montano,monica@scrippsheaIth.org
Subject: Note Psychiatric Hospital in Eastlake .
N/amjngi,
Ezte�hal To whom this may concern,
Email It has come to my attention and many of the residents of Eastlake that there is a proposed intent to
open a Psychiatric Hospital in Eastlake. We are very concerned about this and against It. We are all
in favor of having a Psychiatric Hospital for people in need in our community, we just want It to be relocated in the
correct spot. In the showroom place their are many family oriented places where we take our children. Eastlake is
a family oriented neighborhood and should be kept that way. A Psychiatric hospital in Eastlake in a residential
area is not the correct place. Please take Into consideration the voice of our community. Thank you
Get Outlook for iO5
Caroline Youn
From:
Patricia Salvacion
Sent:
Monday, May 20, 2019 10:41 AM
To:
Caroline Young
Subject:
FW: Proposed Eastlake Psychiatric Hospital
Sharing
From: Gloria Truman
Sent: Monday, May 20, 201910:39 AM
To: Kelly Broughton <kbroughton@chulavistaca.govr, Patricia Salvacion <psalvacion@chulavistaca.gov>
Subject: Re: Proposed Eastlake Psychiatric Hospital
Warning:'
Fx°4emal_
Ema)I Dear Patricia & Kelly,
I am writing you regarding the proposed Eastlake psychiatric Hospital. I have been actively researching
facilities such as these and am concerned about the currently proposed location.
Psychiatric hospitals are needed in San Diego but it is of utmost importance thatthe propersite be selected to ensure the
preservation of current neighborhood character, patient safety, community safety and facility success.
I'd like to make you aware that several business owners expressed their concern to me regarding safety for their patrons.
.One business owner even mentioned not renewingtheir lease If this site gets approved. Our family so appreciates the
businesses in showroom place and I fear that because many are geared toward families, the approval of the hospital permit
Will: 1. Scare off patrons & 2. Businesses will close/move.
My concerns are directly connected to the fact that elopements (escapes) are an expected event within hospitals. Both for
Involuntary patients and voluntary. Because of the wide range of mental Illness being treated at this facility it significantly
Increases the chance of a dangerous event occurring. I'd like to share this article with you regarding elopement:
ham://wwwosvchiatricnumine oMZarticle/50883-9417(12)00129 X/odf
Thank you for thoroughly considering the communities concerns.
Bbi Luko
Caroline Youn
From:
Patricia Salvacion
sent
Monday, May 20, 2019 12:13 PM
To:
Kelly Broughton; Caroline Young
Subjeat:l
FW: Opposition to the Proposed Psychiatric Hospital in Eastlake/Rolling Hills Ranch
Sharing...
From: Brad & Katy Davis <
Sent: Monday, May 20, 201911:59 AM
To: Patricia Salvacion<psalvacion@chulavlstam.gov>
Subject; Opposition to the Proposed Psychiatric Hospital in Eastlake/Rolling Hills Ranch
Dear Ms Salvacion,
My wife Katy and I are writing to let you know we MOST STRONGLY OPPOSE the proposal to build a Psychiatric
Hospital in Eastlake/Rolling Hills Ranch. We live at 797 Creekside Place, which backs up to the lots in question. We have
lived in Chula Vista an and off since 2004 happily raising our family and contributing to our community; my wife as a Wolf
Canyon Elementary Teacher, and myself as a Naval Officer,
We OPPOSE the building of the Psychiatric Hospital far the following reasons
1) Eastlake/Rolling Hills is a quiet, safe and Idyllic family community. Building a large medical center - of any type - at the
proposed location would be grossly out of place.
2) The proposed location backs up closely to two neighborhoods and overlooks Eastlake Middle School; this is not
compatible for a facility which caters to high threat and dangerous patients.
3) There are NO support facilities which could assist this facility anywhere nearby, Including: City social service centers,
sufficient public transportation and most importantly, a police station. Here is a link pertaining to recently escaped
psychiatric hospital patient, can you guarantee this won't happen here? Is this acceptable?
https://www.nola.com/crime/2019/02/nopd-searches-for-psychiatric-oatient-who-ran-from-local-hospital html
4) Eastlakeis'an incredible place to raise a family - allowing this Psychiatric Hospital to be built here Is misguided and will
forever change the chane of out community, adversely affecting thousands of families.
5) Acadia has a long history of questionable business practices and lawsuits. This can not be ignored or tolerated.
6) Facilities like this should be placed adjacent to Hospitals and City support services, not tucked far away in a cul-de-sac
backing up to parks, playgrounds and school bus stops.
Thank -you for your time and we hope you support. Please feel free to contact either of us if you have any questions.
Additionally, feel free to forward this emali to Acadla/Scripps. We can use your assistance in helping us keep our
community one that is SAFE, family focused and the envy of the South County!
Sincerely,
Brad & Katy Davis
This document will be used to petition against the special circumstance zoning permit,
SPECIAL CIRCUMSTANCES REGULATIONS. The following findings shall be met in orderto
find that a Use Regulation is consistent under Special Circumstances with the compatibility
matrix, Section 2050:
a. The Use Regulation Is consistent with the applicable community plan. The Community plan
has spoken for itself with the creation of family friendly businesses, Most Industrial companies
like large furniture stores has all gone out of business and replaced with family friendly business
that have fostered the creation of a large community hub.
b. The Use Regulation is consistent with, or applied under special circumstances in, the majority
of Land Use Designations that border the subject parcel(s). The majority of land use
designations in the surrounding area are not identified as similar land use designations, and
would all require special circumstance zoning permits.
c. The Use Regulation is compatible with the surrounding land uses, with consideration given to;
1. Density or intensity of potential uses; The population density consists of single family homes
and business that cater to children and families. Potential issues that could arrive are dangers to
public safety due to elopement, possible Increase in homelessness in the area, fraffc increase
raising safety concerns for children In the area
2. Availability of public facilities, services and utilities; There are absolutely no related facilities In
the immediate vicinity that provide necessary or related services to support the building of this
facility in this location, It is well documented in public record that Chula Vista police and
emergency response times have not met standards for many years, a problem that is even
worse on the east side due to the size of the service regions and time it takes to traverse them.
Thio influx of people from outside of the city with possibly limited resources to return will only
exacerbate that further.
This facility is approximately 1 mile from -the nearest bus stop.
3. Harmony with the neighborhood character; This is against the harmony of the neighborhood
character. Our neighborhood consists of single family homes, community parks, and family
friendly businesses and churches. Having a large hospital where patients are transported by
police and ambulance goes against the neighborhood character
4. Capacity and character of surrounding streets; Traffic in the area Is already bed enough, and
the facility Is being built In a location far away from major access roads and freeways. It is also
located In a Cul de Sac and has only one exit/entrance, Easily accessible patient transport to
and from this facility remains a concern (There is toll road, and access to to a highway is almost
10 miles away, meaning patient transport will occur on neighborhood stiaete). Public
transportation system In the area remains a concern (it Is a 2 hour bus ride from Hlllcrest),
5. Any other relevant impact of the potential use.
7-12 2072 d. A General Plan Amendment to an appropriate Land Use Designation that would
allow for the Use Regulation to be consistent and therefore not a special circumstance, Is
infeasible as determined by the Director after consideration of the General Plan and applicable
Community Plan. e. Additionally, a study shall be submitted by the applicant that the proposed
Use Regulation meets at least one of the following:
1. There is a demonstrated need for the potential uses of the proposed Use Regulation and
there is insufficient land suitably zoned in the Community Planning Area to meet the
demonstrated need. Additionally, the application of the proposed Use Regulation would not
result in a scarcity of the existing Use Regulation within the community planning area or,
Please provide patient statistics from our local zip codes that receive mental health services -
This facility is not being built for local community members, and will be primarily used by people
outside of our community,
2. The site characteristics make it physically Impossible to implement uses allowed with the
existing Use Regulation. Such constraints may Include, but are not limited to lot configuration,
lot size, topography, drainage, adjacent land use, access, traffic congestion, noise, air pollution
or other factors affecting health, safety or welfare. The study submitted subject to e.1 or e..2
shall be reviewed by the Director and Included as part of the rezone findings for consideration.
These concerns are noted above.
Adjacent land use is family oriented business and community parks.
Access Is limited as there is only one service road leading directly to the location, and getting
there requires use of local neighborhood roads.
Traffic congestion will Increase in the area, and may impact child safety near 10001 business that
cater to there.
011ier factors that affect health, safety, and welfare are the abundant elopement concerns that
occur in these facilities, and the proximity of people who have been deemed "a danger to self or
others' to our homes, parks, and businesses, all catering to families and children,
Caroline Young
From
Kelly Broughton
Sent:
Monday, May 20, 201911:31 AM
To:
Patricia Salvation; Caroline Young; Steve Power
Subject:
FW; Psychiatric Hospital- Showroom Place
FYI
--Original Message ---
From: bill stellln
Received: Monday, 20 May 2019, 11:2SAM
To: Kelly Broughton [kbroughton@chulavistaca.gov]
Subject: Psychiatric Hospital -Showroom Place
Kelly,
I am a resident of Rolling Hills Ranch (and one of five community leaders in charge of fighting the location of this
facility). I live approximately one -hundred yards away from Showroom Place, the proposed location for a new
psychiatric hospital, i am just one of many local residents who have learned of the proposed building of this
facility. Our community is extremely concerned regarding the building of this hospital. Our community is
comprised of journalists, paramedics, police officers, firefighters, teachers, nurses, and lawyers, all actively
involved in fighting the construction of this facility, many ofwhom have fust hand knowledge of the impact these
facilities can have on a neighborhood. The overwhelmingly majority of community members I have spoken with
are highly against the building ofthis facility: Our online petition has received over 2500 signatures. Our efforts
have attracted the attention of local television, radio, and newspaper,
We are not tyrants, or anti -mental health. Weare a simple collection of families who moved into this arca with the
idea that massive hospitals such as this were NOT in our backyards; that our children could play safely on their
streets and in their parks. The primary partner, Acadia Healthcare, has a laundry list of complaints against them,
and have been involved in some extremely concerning lawsuits. This is not the type of company our community
would trust to be associated with a 120 bed psychiatric facility. The facility is being built directly in the middle of
our neighborhoods a few feet away from a community park, a school bus stop, multiple schools, and businesses
that cater to young families and children. Our backyards, where our children play are located less than 100 yards
from the proposed site. We have done a walk through of the businesses in Showroom Place, and have bean in
contact with owners, and regional managers of the businesses and churches located in that area. Every single
person wespoke to has expressed deep concern over the location of this facility and many have vowed to move
their businesses if this facility is built in the.proposed. location.. They have become active members in our fight,
Our numbers continue to grow daily,
The irresponsible partnership with Acadia Healthcare is something that our community can not tolerate. The
proximity of Showroom Place to our neighborhood and local businesses is extremely unsettling to our community
members and local business owners. There are other available locations, some outside of Chula Vista altogether.
Nathan Fletcher has even proposed a location at 4307 Third Ave in the Hillcrest area (a county owned property
- that is within close proximity to USC San Diego Medical Center) that is slated to become luxury condominiums. A
company such as Acadia, who has along history of patient elopement, safety violations, lawsuits, allegations of
rape, sexual misconduct, child endangerment, fraud, elder abuse, and patient death does not seem like the type of
company we want in the middle of our neighborhood, directly next to where our children play. The history of this
company, and the potential dangers a psychiatric hospital could pose to our community will be brought to light,
and is a primary focus of this community. The history of this company is well documented, and it doesn't take
much research to identify that this company is dangerous for our community.
Not only do the aforementioned concerns, play a role in our concerns, but the site location seems like a poor
choice. The Community plan has spoken for itself with the creation of family friendly businesses in the
area: Most Industrial companies like large furniture stores has all gone out of business and replaced
with family friendly business that have fostered the creation of a large community hub, The majority
of land use designations in the surrounding area are not identified as similar land use designations.The
population density of the area consists of single family homes and business that cater to children and
families, Potential issues that could arrive are dangers to public safety due to elopement, possible
increase in homelessness in the area, traffic increase raising safety concerns for children in the area.
There are absolutely no related facilities in the immediate vicinity that provide necessary or related
services to support the building of this facility in this location. It is well documented in public record
that Chula Vista police and emergency response times have not met standards for many years, a
problem that is even worse on the east side due to the size of the service regions and time it takes to
traverse them, The influx of people from outside of the city with possibly limited resources to return
will only exacerbate that f irther.This facility is approximately 1 mile from the nearest bus stop. Our
neighborhood consists of single family homes, community parks, and family friendly businesses and
churches. Having a large hospital where patients are transported by police and ambulance goes against
the neighborhood character. Traffic in the area is already bad enough, and the facility is being built in
a location far away from major access roads and freeways. It is also located in a Cul de Sac and has
only one exit/entrance. Easily accessible patient transport to and from this facility remains a concern
(There is toll road, and access to to a highway is almost 10 miles away, meaning patient transport will
occur on neighborhood streets). Public transportation system in the area remains a concern (it is a 2
hour bus ride from Hillcrest) and the closest bus stop to this facility is a mile away.
We will be attending city council meetings, city planning commission meetings, doing neighborhood
walks, and distributing informational fliers to all of Rolling Hills Ranch and Eastlake. We are an
active, educated, and extremely organized movement. We have made tremendous progress over the
past three:.weeks and as our movement grows we will only become stronger. We are asking for your
assistance in preventing the building of this hospital on its currently proposed location. Your
participation in this movement, and any assistance that you could give us would be greatly
appreciated.
I look forward to seeing you at the next few city planning commission meetings.
For your convenience I am linking you (below) a few articles related to Acadia, and issues of patient elopement
that plague the mental health industry.
sincerely,
Bill Stellin
ELOPEMENT (ACADIA)
https //mtstandard com/news/local/oteeon-complaint-runaways-assaults parent company s troubles among
naw./article 3d090ebb-e804-54af-8152-f40c9b6al696htm1
ELOPEMENT (NON ACADIA)
https'//www psychiatricnursin¢ ore(artiole/50883-9417(12)00129 X/pdf - -
https://www news5clevelmd com/new&4ocal-news/oh-euvahoea/psvch natient flees metrohealth takes car with
baby -inside -
bttps'//www newswcek com/cleveland-manhunt-escaped-psychiatric-prisoner-wearing-hospital gown 1399960
hats://www.cm com/2016/04/07/us/washineton-mental-hosPital-dangerous-escane/index html
hfos•//llypost wm/2019/02/01/li-psveh-pationt-coca missine after iumpine from ambulance/
UPDATE' Suspect in Custody After Escapin¢ Trenton Psychiatric Hospital
MMMUPDATE: Suspect in Custody After Escaping Mor
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https/ikval com/politics/nation-and-wortd/gallerylescaped-usychiaMc-patient-bad-planned-bombing-07-12-2016
https•//wwincwsradio mdio mff /articles/state-police-find-man-who-escapedrosyebiatrie-hospital-van
https•//www nota com/mme/2019/02/nopd-seazches-for-psvch,aMcl)atient-who-ran-from-local-hospital.html
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https//www knoe wm/content/news/Police-in-Little-Rock-looking for-patient-who-escaped-nsvchiatric-hosoilal-
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httpF//�Www.eastba),times.com/2o 17112/07/sheriffs-deputies-recapture-patienl-after-violent-hospital-esca
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h"s'//www latimes com/archives/la-xpm-2003_mar-D7-me-mental7-story.html
httm,//www scattletimes com/seettle-news/do2ens-have-escaped-from-westem-state-sinee-2013-review-finds/
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https;//www.dist)atch.com/news/20171008/patient-escapes-hilltop-psychiatric-hospital-considered-dan gerous,
ABUSE/NEGLIGENCE
ht, tt s•/hvwwcehrintore/2019/02/13/acadia-healthcare-more-abuse-more-need-for-government-oversiPhU
https'//www cchrint org/2019/01/23/psychiatric-for-profit-hospitals/
ht_pt s://www-aboioumal-com cdn =pproiect ore/v/s/www abgioumal com/1279725/cqd treatment center sued
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httys://www ukansasonline wm/news/2017/aup)12/lawmaker-to-retire-from-ascent-child-ca-1/
https://www.dispatch.com/news/20180510/legal-advocacy-group-calls-on-state-to-protect-patients at troubled
psychtatno-hospital _
FACILITY CLOSURES
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6
Oregon complaint, runaways, assaults, parent company's troubles among new Acadia CE... Page I of 14
https:Hmtsta ndard.com/news/local/o rego n -complaint -run aways-assau Its-parent-com pany-s-troub les-
among-new/ardcIe_3d090cbb.e804-54af-8152-f400b6a 1696.html
OPIG
KIDS IN CRISIS, CARE IN QUESTION
Oregon complaint, runaways, assaults, parent
company's troubles among new Acadia CEO's
challenges
From the Complete coverage: Kids in crisis, care in question series
TED McDERMOTTted.mcdermott@mtstandard.com Apr23,2019
99¢ YOUR rIRST MONTH!
Workers put up a chain I Ink fence inside Acadia Montana Treatment Center, 55 Basin Creek Road in
httns://mtstandard.comJnews/Iocalloregon-complaint-runaways-assaults-parent-company-s... 5/20/2019
Oregon complaint, runaways, assalts,pam-t company's trOubles among tiie�A-cadia M 'Page 2 — – -
Butte. The facility is building a second fence to deter escape attempts.
Meagan Thompson, The Montana Standard
Last in a three-day series.
It got down to 10 below zero on Dec. 7, but that didn't deter three
teenagers — one of them not wearing shoes — from kicking open a locked
door at Acadia Montana, climbing over a tall fence and running away from
the children's residential psychiatric treatment center where they were supposed
to be receiving therapy.
Peggy Cunningham, Acadia Montana's relatively new CEO, was there that
night.
The police were called and a search was started. Around 5 a.m., according to
police reports, the missing teens went to a nearby residence seeking help. When
officers arrived, the teens were taken into custody.
They were sent to St. James Healthcare to be evaluated, then returned to Acadia
Montana. They. were required to change clothes to ensure they weren't carrying
contraband and were placed on 24-hour restriction.
Their families were told about what happened, Cunningham said, and the
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Oregon complaint, mnaways, assaults, parent company's troubles among new Acadia CE... Page 3 of 14
incident was discussed with other residents.
Cunningham, who says she knows "every kid" in the facility and prides herself
on her hands-on approach, says she was involved throughout.
"I don't avoid the situation when there's trouble," Cunningham said in an
interview with The Montana Standard two days after Christmas.
For further evidence of Cunningham's willingness to confront trouble, consider
that she came to Acadia Montana at all,
srs
Acadia Montana is a subsidiary of Acadia Healthcare, a publicly traded
Nashville, Tennessee -based company that operates a network of 586 behavioral
healthcare facilities with approximately 18,000 beds in 40 states, the United
Kingdom and Puerto Rico, according to the company's website.
The company has been the repeated subject of complaints, lawsuits and
allegations of abuse.
Earlier this month, for example, another Acadia facility that offered residential
treatment for children and adolescents shut down after a series of lawsuits
"alleging the company failed to protect its clients from physical and sexual
abuse from its workers and other patients," according to the Nashville Post.
The Post notes that the "suits cite internal fight clubs instigated by facility staff
members, sex between staff and young patients, the unchecked spread of HIV
among patients and excessive use of restraints on children — more than 30
times in 60 days, according to filings."
https://mtstandard.comincwsAocalloregoncomplaint-runaways-assaults-parent-company-s... 5/20/2019
Oregon complaint, un;iwayi, asmWts, pasentdpigpany s froub es among newA=14ML�---page-4 of 14- - ---
Also this month, the Chicago Tribune reported that six former patients of an
Acadia facility in Illinois alleged "intentional infliction of emotion distress"
because the facility hired a therapist who was later charged with 62 felony
counts for allegedly sexually assaulting or abusing patients during therapy
sessions.
As reports of failures inpatient care have mounted, the company's finances
have suffered and executives have been pushed out.
In December, the company's board removed longtime CEO and Chairman Joey
Jacobs, replacing him with Debra Osteen, who previously served as president of
the behavioral health division of Universal Health Services, another major
publicly traded healthcare company. And last month, Brent Turner, Acadia's
president, left the company.
According to a November article in Axios, "Over the past few years, Acadia
Healthcare has saddled itself with huge amounts of debt, and top executive
insiders have sold off stock in droves — a situation that doesn't inspire
confidence in the future of the company."
Acadia Healthcare stock was just more than $81 in 2015. But it has declined
substantially since then and was valued at just over $29 this week.
Despite such turmoil, Cunningham said in December that instability at the
corporate level had "not trickled down here at this point" and argued that the
for-profit model provides benefits over a public model.
"I think they (for -profits) have the opportunity to provide additional resources
that may not be available otherwise," Cunningham said, adding that such
companies "can put money back into facilities and improve care" and provide
resources and training "that may not be available in a nonprofit model."
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Oregon complaint, runaways, assaults, parent company's troubles among new Acadia CE... Page 5 of 14
While the facility is private, Montana Medicaid reimbursed Acadia $6.3 million
for the in-state services it provides as a Psychiatric Residential Treatment
Facility, according to Jon Ebelt, public information officer for the Montana
Department of Public Health and Human Services.
Ebelt noted that Acadia also received about $169,000 in Medicaid direct care
wage allocations for support of Acadia Montana and approximately $300,000
for outpatient services.
Montana Medicaid also reimbursed Acadia Healthcare $2,7 million to serve
Montana clients in out-of-state PRTP facilities.
The diagnoses Acadia Montana treats, according to Cunningham, include major
depressive disorder, generalized anxiety disorder, disruptive mood
dysregulation disorder, attention deficit/hyperactivity disorder, post-traumatic
stress disorder, oppositional defiant disorder, and autism. It also accepts
patients with intellectual and developmental disabilities and chemical -
dependency issues,
"Many come from backgrounds of trauma and abuse and therefore they need
some skills they haven't picked up in life," Cunningham said in December.
While the vast majority of patients require the consent of a parent or guardian to
receive treatment, Cunningham noted that "not a lot parents call and say, `Will
you take my kid?"' Instead, she said, therapists and psychiatrists typically refer
children and their parents or guardians to Acadia Montana, "depending on what
has worked and what hasn't worked." -
In addition, youth courts can order a child to receive care at the facility, though
Cunningham noted that no patients had been referred to Acadia Montana from
the juvenile justice system during her tenure.
https:llmtstandud.com/newsAwalloregoncomplaint-runaways-assaults-parent-company-s. 5/20/2019
"Oregonedatplaint,gumwayarassautts;-pgentwrnpany'stroublesamongmwAcadia-eE.�;-Page-(roFt4*--- --
Cunningham said there is a "different goal for every kid," but that there is an
overarching aim of Acadia Montana's treatment program: "The goal is so that
they (patients) can function better in the setting they return to than they were
functioning when they came here."
`,i certainly knew that they'd had problems in the past," Cunningham said of
Acadia Montana in December.
But, she noted, she was also aware that "efforts had been made to minimize
those problems."
Her goal during her time leading Acadia Monta". she said, is simple: "I hope
to hire an adequate staff, to build our census, and I hope to build a stable
atmosphere so the future incidents will be minimized."
She also acknowledged that those aims will face obstacles.
"There are days that we have problems. And when we have problems, we're
committed to facing them head on," Cunningham said. "And we have problems
because we have some tough kids that we work with. But our kids are good
kids."
Cunningham couldn't promise Acadia Montana's road ahead would be trouble-
free when interviewed in December, but she was optimistic it would provide a
smoother path forward for the patients it serves,
"I believe there's a future where the dips in the road are a lot less severe,"
Cunningham said.
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Oregon complaint, runaways, assaults, parent company's troubles among new Acadia CE... Page 7 of 14
She then unlocked a metal door and led two staffers from The Montana
Standard through the long, institutional hallways of Acadia Montana, showing
off a classroom where residents do schoolwork, pointing to a room where
adolescents were in group therapy, poking her head into an empty gymnasium,
and unlocking the door of an unoccupied room with a single window located
high on the wall, above a bare bed.
Cunningham oversees about 170 full-time employees who are responsible for
the treatment of an evolving number of kids with a range of behavioral,
psychiatric and developmental disorders.
"We do good work," Cunningham said. "And I'm proud of the work my staff is
doing."
But she also acknowledged that she has implemented "significant changes"
since taking over leadership of the facility from Carter Anderson, the facility's
previous CEO and now the Administrator of DPIIHS's Quality Assurance
Division, which oversees the facility and many other in the state. (See related
stories.)
She said she looked at statistics about the use of seclusion and restraint when
she got on the job and thought it was "more than we needed." That led to a
campaign to reduce the use of these tactics. While she declined to share that
data, she did say it has declined "significantly."
She said she also asked that everyone be retrained in MANDT, the facility's
technique of choice, as of December, for preventing and de-escalating
threatening behaviors and for restraining those whose behavior might barm
themselves or others.
She said she held weekly meetings and trainings.
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Oregon complaint, mdaways, assa—ults, parentcompany soubles—among new Acadia CF -,, Page 8-of-1-4---- ---
"We made sure everybody was trained appropriately," she said.
She said she hired about 40 additional staff between August and November
"across multiple disciplines."
Instead of looking for people with experience in the behavioral health,
Cunningham said she looks for individuals with the right "attitude and
commitment."
"I believe that if you have the right attitude and heart that I can teach you
skills," Cunningham said.
And she said she has worked to give her staff the resources they need to
succeed.
"We have done things to try to make them (the staff) feel real supported," said
Cunningham, who has worked in the behavioral health field for some 30 years.
"I have to be invested in my staff if I want my staff to be invested."
She also said in December that the facility was planning to build a second fence
to deter escape attempts. As of this month, that work was underway.
e*a
While Cunningham has embarked on a program of reform, problems have
continued to crop up at the facility south of Butte.
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Oregon complaint, runaways, assaults, parent company's troubles among new Acadia CE... Page 9 of 14
In November, a DPHHS complaint inspector found that Acadia Montana did
not properly report an allegation of abuse or neglect.
According to the inspection report, six residents escaped the facility by
climbing over or going "through" a fence on Sept. 11, 2018. Two of the
residents returned on their own, and four were returned by police. In addition to
getting the date wrong, the facility reportedly "did not state staff were unable to
control residents. They broke through five doors inside the facility to gain
access outside. The residents then climbed the fence" and escaped.
The complaint inspection also found that the "facility had prior knowledge that
both residents had the potential to elope (escape) from the facility but failed to
implement adequate supervision of the residents to prevent the elopement from
occurring on 09/11/2018."
The complaint inspectors also found on Oct. 1, while investigating "a different
matter," that a police investigation occurred on Sept. 21 "regarding the
allegations of sexual assault" of one resident by another.
Then, on Dec. 7, there were the three teens who escaped on a sub -zero night,
The next week, police responded to reports of four assaults at Acadia Montana.
One of the reported assaults allegedly involved one resident punching another,
The other three assaults allegedly involved a resident punching three staff
members, during and after an escape attempt.
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— ----Uregon complaint rnn_aways, assaults, partA(gj _ Vmy'atroubles arnpngnewAradia G.. Page 10 of 14'
On Jan, 9, a parent of one 15 -year-old Acadia patient called Butte police and
filed several complaints against another 15 -year-old patient for three assaults
allegedly committed at the facility in December. According to police, the parent
claimed their son was punched in the face on three separate occasions and
members of Acadia's staff agreed to serve as witnesses in the case.
According to Cunningham, staff who are assaulted by residents get to decide
whether to press charges. But, she added, doing so can serve as "a way of
making a kid understand consequences."
Then, in March, lawyers, officials and the mother of a 9 -year-old Oregon girl
who was chemically and physically restrained began to look into issues at the
facility, sparking outcry in her home state and leading to her removal from the
facility earlier this month.
Cunningham, who spoke to The Montana Standard in December, declined to
comment after the removal of the Oregon child.
Further evaluations of the facility under Cunningham's watch are forthcoming.
Inspectors from Alaska completed their annual survey of Acadia Montana on
April 8, and a report about their findings should be available soon.
In addition, the the Montana Mental Disabilities Board of Visitors, which is
housed in the Office of the Governor and aims to provide outside oversight of
mental health programs in the state, recently completed a site review of the
facility and could have a report released as soon as later this month.
Asked whether DPHHS has conducted a complaint investigation of Acadia
Montana in response to recent revelations from Oregon about the injected
medication and seclusion, Ebelt said, "We don't comment on in -process
investigations."
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Oregon complaint, runaways, assaults, parent company's troubles among new Acadia C.., Page 11 of 14
Sara Gelser, an Oregon state senator, told The Montana Standard this week that
the treatment of 9 -year-old Oregon girl and other recent reports of issues at
Acadia Montana are "deeply concerning."
When kids try to ran away on a subzero night, for example, Gelser said it's a
"sign of trouble" that's often viewed as a problem with the young patients
rather than with the place and system they are desperately trying to escape.
As such issues persist over the years, Gelser said the problems become abstract,
though the effects on children's lives are real.
"The level of risk to these kids is extraordinary," Gelser said. "It will take years
to undo the damage done to the kids,"
And while she acknowledges the challenges posed by the kinds of kids Acadia
Montana treats, Gelser believes the kind of care offered there only exacerbates
their issues.
"I look at these kids and people like to say that they're broken," Gelser said.
"When I go back and look at the files and the case histories, it's a story of all of
the adults in their lives failing them. And then we go back and punish them
when they're dysregulated."
According to Gelser, chemically restraining kids with antihistamines and
placing them. in locked seclusion are such forms of punishment, though the
children being treated this way "don't necessarily know that it isn't right....
They don't even know that they can ask for help."
And she says that laws and rules that make it difficult for outsiders to see
what's going on inside "dark locked places" like Acadia Montana only serve to
make it harder for the young patients to get help when things go wrong.
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Oregancomplaint, nuiaways, assaults, parent company's TioulbleS;amonmW Acadia C. -.-Page 17 of -14- - ---
"It doesn't protect the kids," Gelser said. "It protects the systems and the adults
... and leaves the kids powerless and without allies."
Gelser added, "If you're 9, how do you know who to call, if you're even
allowed to touch a telephone?"
While Cunningham continues her efforts to improve the facility, Gelser is
pessimistic about the prospect of meaningful change.
"It doesn't take a rocket scientist to figure out that something is very, very
wrong," Gelser said. "We shouldn't be putting kids there and hoping for the
best."
�\•-Preaioos�
MORE INFORMATION
Next
https:llmtstandard.aominewsllocalloregon-complaint-runaways-assaults-parent company -s... 5/20/2019
(Oregon complaint, runaways, assaults, parent company's troubles among now Acadia C... Page 1.1 of 14
Acadia Montana: Use of injected medication, tolerated for years instate, draws Oregon
outrage
• Regulation of Acadia Montana overseen by former CBO
• Through multiple owners, managers, Butte's Acadia Montana has consistently found trouble
Ted McDermott
Assistant editor
In this Series
Complete coverage: Kids in crisis, care in question
Apr 21, 2019 article
Acadia Montana: Use of injected medication, tolerated for years in
state, draws Oregon outrage
Apr 21, 2019 article
https://mtstandard.corn/news/local/oregmroomptaint-rrmaways-assantts-parent-company-s... 5/20/2019
Oregon complaint, tmnaways-assaults- pareatcampany'ytmutyks aamngnnrAcadia C—...-Aag"4-of 14,- - , --- -
Regulation of Acadia Montana overseen by former CEO
Apr 22, 2019 article
Through multiple owners, managers, Butte's Acadia Montana has
consistently found trouble
v 4 updates
https:/lmtstandud.comJnewsllocalloregon-complaint-runaways-assaults-puentcompany-s... 5/20/2019
Caroline Youn
From:
Patricia Salvation
Sent
Friday, May 17, 2019 9:41 AM
To:
Kelly Broughton; Caroline Young
Subject:
FW: Proposed psych facility in Eastlake
Sharing...
From: mark flint
Sent: Friday, May 17, 2019 12:10 AM
To: Patricia Salva cion <psalvaclon@chulavistaca.gov>, MarySaIas <MSalas@chulavlstara.gov>; Jill Galvez
<jmgalvez@chulavistaca.gov>; Steve C. Padilla <spadllla@chulavistaca.gov>; Mike Diaz<mdiaz@chulavistaca.gov>;
rarpowich.stephen@scrippshealth.org; mike @iredevelopment.com;John McCann <jmccann@chulavistaca.gov>
Subject: Proposed psych facility in Eastlake
Woo ing:.
Mental '
Small ` Hello. I am writing to express m concerns regarding the proposed inpatient _ psychiatric facility in Eastlake,
Chula Vista. I am a resident of Rolling Hills Ranch, adjacent to the parcel where the facility is proposed. My
home is less than one mile from the parcel. My children's school bus stop on River Rock Road Is mere feet from the
Proposed facility site.
I, and my neighbors, have serious concerns about the possible addition of this facility to our neighborhood.
Here are my concerns:
Community Concerns: Community members (including some who actively work with psychiatric patients) have the
following concerns:
1. Poor Partner: Acadia, who will be an BOY owner of this facility, is riddled with lawsuits and allegations regarding fraud,
elder abuse, and child abuse.
2. Poor Release policy: Patients driven in will be released with limited options to get back home. Residents are concerned
With loitering and an Increase in homelessness. The idea that careful discharge planning will mitigate the community's
concerns is naive. There is a dire lack of resources for the mentally ill, dually diagnosed, homeless population.
3. Location: This hospital would service a large region but is planned for an area with very limited public transportation. It is
miles away from the Scripps Hillcrest hospital and only quickly accessible via tall road, which equates to limited access for
patients. Luke Bergmann, director of behavioral health for San Diego County stated he is "concerned when a stand-alone
facility is built many miles away from a hospital, that such a facility be connected to the "integrated" system of care that
Includes outpatient resources.", San Diego Union -Tribune
4. Proximity to Children: Increase In traffic, loitering, and ham elessness create safety concerns for the many schools, parks,
and children In the area. Additionally, most of the businesses in "The District," which is right next door to the proposed
site, are geared toward children and families (Floaties Swim School, Kldventures, Sky Zone, Speed Circuit, Play City, Little
Artists, Sylvan, Ninja Factory, Darizart).
S. Limited Police: Chula Vista does not have enough police and Eastlake has the fewest patrols assigned to handle Issues
arising from the facility or those released.
6. Increase In traffic: Increase in sirens in an otherwise qulet neighborhood.
7. Decrease In local home values: Data reports Indicate that homes near similar sites had a decrease in value.
This location is inappropriate for an Inpatient locked psychiatric facility. Please explore other locations such as the county
owned 3rd Ave property in Hillcrest identified by county supervisor, Nathan Fletcher. This location has adequate public
resources to support the discharge planning of patients and is within close proximity to other needed medical facilities.
Thank you,
Mark Flint
Sent from my Whone
7
Caroline Youn
From:
Patricia Salvacion
Send: -
Thursday, May 16, 2019 9:24 AM
To.
Kelly Broughton; Caroline Young
Subject:
FW: proposed inpatient psych Facility In Eastlake
Sharing...
From: sue darwlsh _
Sent Wednesday, May 15, 2019 8:31 PM
To: Kelly Broughton <kbroughton @chulavistaca,gov>; Patricia Salvacion <psalvacion@chulavistaca.gcv>; Mary Salas
<MSalas@chulavlstaca.Ji JIII Galvez <jmgalvez@chulavistaca.gov>; Steve C. Padilla <spadilla @chulavistaca.gov>; Mike
Diaz<mdiaz@chulavistaca.gov>; carpowich.stephen@scrippshealth.orc mike@iredevelopment.com; John McCann
<jmaann @chulavistaca.gov>
Subject: Fw: proposed inpatient psych facility in Eastlake
M
Hello. I am writin to ex ress m concerns re ardin the ro osed
9 P Y regarding proposed
inpatient psych facility in Eastlake, Chula Vista.
Here are my concerns:
Community Concerns: Community members (including some who actively work
With psychiatric patients) have the following concerns:
p
1. Poor Partner: Acadia, who will be an 80% owner of this facility, is riddled with
lawsuits and allegations regarding fraud, elder abuse, and child abuse.
2. Poor Release policy: Patients driven in will be released with limited options to
get back home. Residents are concerned with loitering and an increase in
homelessness. The idea that careful discharge planning will mitigate the
community's concerns is naive. There is a dire lack of resources for the mentally ill,
dually diagnosed, homeless population. We struggle with this every day at the
hospital.
3. Location: This hospital would service a large region but is planned for an area
with very limited public transportation. It is miles away from the Scripps Hillcrest
hospital and only quickly accessible via toll road, which equates to limited access
for patients. Luke Bergmann, director of behavioral health for San Diego County
stated "he is concerned when a stand-alone facility is built many miles away from a
hospital, that such a facility be connected to the "integrated" system of care that
includes outpatient resources." - San Diego Union -Tribune
4. Proximity to Children: Increase in traffic, loitering, and homelessness create
safety concerns for the many schools, parks, and children in the area.
5. Limited Police: Chula Vista does not have enough police and Eastlake has the
fewest patrols assigned to handle issues arising from the facility or those released.
6. Increase in traffic: Increase in sirens in an otherwise quiet neighborhood.
7. Decrease in local home values: Data reports indicate that homes near similar
sites had a decrease in value.
Please explore other locations such as the county owned 3rd Ave property
identified by county supervisor, Nathan Fletcher.
Thank you,
Sue Darwish
Caroline Youn
From:
Patricia Salvation
Sent:
Thursday, May 16, 2019 9:24 AM
To:
Kelly Broughton; Caroline Young
Subject
FW: proposed Inpatient psych facility in Eastlake
Sharing...
...... _. _.
From: KA7 Co arusso
Sent: Wednesday, May 15, 2019 8:26 PM
To: Kelly Broughton <kbroughton@chulavistaca.gov>, Patricia Salvacion <psalvacion@chulavistaca.gov>; Mary Salas
<MSalas@chulavistaoa.gov>; Jill Galvez <jmgalvez@chulavistaca.gov>; Steve C. Padilla <spadilla@chulavistaw.gov>; Mike
Diaz 2md iaz@chulavistaca.gov>; carpowich.stephen@scrippshealth.org; mike@iredevelopment.com; John McCann
<jmccann @chulavistaca.gov>
subject: Fvv: proposed inpatient psych facility in Eastlake
warA!Jrs
External
EmatL Hello. I am writing to express my concerns regarding the proposed
inpatient psych facility in Eastlake, Chula Vista.
Here are my concerns:
Community Concerns: Community members (including some who actively work
with psychiatric patients) have the following concerns:
1. Poor Partner: Acadia, who will be an 80% owner of this facility, is riddled with
lawsuits and allegations regarding fraud, elder abuse, and child abuse.
2. Poor. Release policy: Patients driven in will be released with limited options to
get back home, Residents are concemed with loitering and an increase in
homelessness. The idea that careful discharge planning will mitigate the
community's concerns is naive, There is a dire lack of resources for the mentally ill,
dually diagnosed, homeless population.
3. Location: This hospital would service a large region but is planned for an area
with very limited public transportation. It is miles away from the Scripps Hillcrest
hospital and only quickly accessible via toll road, which equates to limited access
for patients. Luke Bergmann, director of behavioral health for San Diego County
stated "he is concerned when a stand-alone facility is built many miles away from a
hospital, that such a facility be connected to the "integrated" system of care that
includes outpatient resources." - San Diego Union -Tribune
4. Proximity to Children: Increase in traffic, loitering, and homelessness create
safety concerns for the many schools, parks, and children in the area.
5. Limited Police: Chula Vista does not have enough police and Eastlake has the
fewest patrols assigned to handle issues arising from the facility or those released.
6. Increase in traffic: Increase in sirens in an otherwise quiet neighborhood.
7. Decrease in local home values: Data reports indicate that homes near similar
sites had a decrease in value.
Please explore other locations such as the county owned 3rd Ave property
identified by county supervisor, Nathan Fletcher.
Thankyou
Kenneth Colarusso
Caroline Young
From:
Patricia Salvacion
sent:
Thursday, May 16, 2019 1123 AM
To:
Caroline Young
Subject:
FW: proposed inpatient psych facility in Eastlake
Sharing...
From: Anthony Colarusso <.
Sent: Thursday, May 16, 201911:20 AM
To: Kelly Broughton <kbroughton@chulavistaca.gov>; Patricia Salvacion <psalvacion@chulavlstaca.gov>, Mary $alas
<MSalas@chulavistaca.gov>; Jill Galvez <jmgalvez@chulavistaca.gov>; Steve C. Padilla <spadilla@chulavlstaca,gov>; Mike
Diaz<mdiaz@chulavistaca.gcv>; carpowich.stephen@svippshealth.org; mike@iredevelopment.com; John McCann
<jmcca nn @chulavistaca.gov>
Subject: Fwd: proposed inpatient psych facility In Eastlake
iNammgi
"real
Email
Hello. I am writing to express my concerns
regarding the proposed inpatient psych facility
in Eastlake, Chula Vista.
Here are my concerns:
.Community Concerns: Community members
(including some who actively work with psychiatric
patients) have the following concerns:
1. Poor Partner: Acadia, who will be an 80%
.. _ ... owner -of this facility, is riddled with lawsuits and
allegations regarding fraud, elder abuse, and child
abuse.
2. Poor Release policy: Patients driven in will be
released with limited options to get back home.
Residents are concerned with loitering and an
increase in homelessness. The idea that careful
discharge planning will mitigate the community's
concerns is naive. There is a dire lack of
resources for the mentally ill, dually diagnosed,
homeless population.
3. Location: This hospital would service a large
region but is planned for an area with very limited
public transportation. It is miles away from the
Scripps Hillcrest hospital and only quickly
accessible via toll road, which equates to limited
access for patients. Luke Bergmann, director of
behavioral health for San Diego County stated "he
is concerned when a stand-alone facility is built
many miles away from a hospital, that such a
facility be connected to the "integrated" system of
care that includes outpatient resources." - San
Diego Union -Tribune
4. Proximity to Children: Increase in traffic,
loitering, and homelessness create safety
concerns for the many schools, parks, and
children in the area.
5 Limited Police: Chula Vista does not have
enough police and Eastlake has the fewest patrols
assigned to handle issues arising from the facility
or those released.
z
6. Increase in traffic: Increase in sirens in an
otherwise quiet neighborhood.
7. Decrease in local home values: Data reports
indicate that homes near similar sites had a
decrease in value.
Please explore other locations such as the county
owned 3rd Ave property identified by county
supervisor, Nathan Fletcher.
Thank you.
Caroline Youn
From:
Patricia Salvacion
Sent
Tuesday, May 14, 2019 12;09 PM
To:
Kelly Broughton
Cc:
_
Caroline Young
Subject:
FW: proposed Inpatient psych facility in Eastlake
Sharing.,.
Front: linda colarusso------�"
Sem: Monday, May 13, 2019 6A4 AM
To: Kelly Broughton <kbroughton@chulavlstaca.gov>; Patricia Salvaclon <psalvacion@chulavistaca.gov>; Mary Sales
<MSalas@chulavistaca.gov>; Jill Gahiez <jmgalvez@chulavistaca.gov>; Steve C. Padilla <spadilla@chulavistaca.gov>; Mike
Diaz <mdiaz@chulavlstaca.gov>; rarpowich.stephen@scrippshealth.org; mike@lredevelopment.com; John McCann
<jmccann @ch ulavistaca.gov>
Subject; proposed inpatlent psych facility in Eastlake
Warning:
EktC.
email Bello. I am writing regarding the proposed inpatient psych facility in
Eastlake, Chula Vista. 1 am a social worker with 25 years of experience with
discharge planning, including discharge of inpatient psychiatric patients. I
worked at Bayvlew Hospital for 2 years and on occasion at Scripps Mercy
San Diego's behavioral health unit. I have worked at Scripps Chula Vista for
11 years.
Here are my concerns:
Community Concerns: Community members (including some who actively work
with psychiatric patients) have the following concerns:
1. Poor Partner: Acadia, who will be an 80% owner of this facility, is riddled with
lawsuits and allegations regarding fraud, elder abuse, and child abuse.
2. Poor Release policy: Patients driven in will be released with limited options to
get back home. Residents are concerned with loitering and an increase in
homelessness. The idea that careful discharge planning will mitigate the
community's concerns is'naive. There is a dire lack of resources for the mentally ill,
dually diagnosed, homeless population. We struggle with this every day at the
hospital.
3. Location: This hospital would service a large region but is planned for an area
with very limited public transportation. It is miles away from the Scripps Hillcrest
hospital and only quickly accessible via toll road, which equates to limited access
for patients. Luke Bergmann, director of behavioral health for San Diego County
stated "he is concerned when a stand-alone facility is built many miles away from a
hospital, that such a facility be connected to the "integrated" system of care that
includes outpatient resources." - San Diego Union -Tribune
4. Proximity to Children: Increase in traffic, loitering, and homelessness create
safety concerns for the many schools, parks, and children in the area.
S. Limited Police: Chula Vista does not have enough police and Eastlake has the
fewest patrols assigned to handle issues arising from the facility or those released.
6. Increase in- traffic: ..I.ncrease in sirens in an otherwise quiet neighborhood.
7. Decrease in local home values: Data reports indicate that homes near similar
sites had a decrease in value.
Please explore other.locationssuch as the area south of chula vista near the 925
fwy and the 905. There is a lot of open land/commercial development in this area
that is not as close to neighborhoods.
Thank you.
Linda Colarusso
Caroline Youn
From:
Patricia Salvation 1
Sent:
Tuesday, May 14, 2019 12:04 PM
To:
Kelly Broughton
Cc:
Caroline Young -
Subject,
FW: City of Chula Vista: Planning Commission - Contact Us
Sharing...
From: Webmaster
Sent: Friday, May 10, 2019 7:28 PM
To: Patricia Salvation <psaIVacion@chulavistaca.gov>
Subject: City of Chula Vista: Planning Commission - Contact Us
A new entry to a form/survey has been submitted.
Form Name:
Planning Commission - Contact Us
Date & Time:
05/10/2019 7:27 PM
Response It:
50
Submitter 10:
62706
IP address:
172.24.96,110
Time to complete:
56 min., 14 sec.
Survey Details
First Name Monica
Last Name Nelson
Email Address
Comments
Good evening.
After 12 years of searching. I finally found the home of my dreams last year in Chula Vista and became a homeowner, I used my
-life savings as a dawn payment and am just so disheartened to hear about this proposed construction. It b one thing to build a
f small outpatient facility to help indMduals with PTSD, eating dlsorders and depression and quite another to bulid a large 120
bed facility with a lockdown ward housing violent and dangerous individuals near schools and families.
Please do NOT approve this project. It's bad for our community, It's bad for our children, and It's bad for Chula Vistal
I
Caroline Young
From:
Patricia Salvation
Sent;
Tuesday, May 7, 2019 11:11 AM
To:
Caroline Young
Subject:
FW: City of Chula Vista: Planning Commission - Contact Us
Sharing...
From: Webmaster
Sent: Tuesday, May 07,201911:09 AM
To: Patricia Sell <psalvacion@chulavistaW.gov>
Subject: City of Chula Vista: Planning Commission • Contact Us
A new entry to a form/survey has been submitted.
Form Name:
Planning Commission - Contact Us
Date & Time:
05/07/201911:08 AM
Response 1:
46
Submitter ID:
62585
IPaddress:
172.24.96.110
Time to complete: 3 min., 16 sec.
Survey Details
Last Name Meaux
Email Address
Comments --. - --
My name is Kyle Meaux and I'm a home owner In the Rolling Hills Ranch community of Chula Vista, rm writing you to notify you
of my severe opposition to the new proposed Behavioral Health Center in the District at Eastlake commercial area. This is an
absolutely Improper location for this .facility. It is close to many kid friendly business and schools. The Communities of Eastlake
and Rolling Hills are known as family oriented communities. It's safe to say, most people in these communities moved here for
this reason. I'm one of those people.I have two small children and the main reason I moved to Rolling Hills Ranch is to raise my
children In a family oriented community surrounded by good schools and family friendly atmosphere. This new proposed facility
will attract the exact opposite of why I moved here,
The release of patients near my neighborhood, potential escape of patients, lack of mass transit, response times for fire and
police to the area, and potentially lowered property values are all significant concerns I would like to raise to you as our
Planning Board.I hope you will strongly oppose this proposed facility and keep the Rolling Hills Ranch and Eastlake
Communities the great family oriented communities they are.
Sincerely,
Thank you,
City of Chula Vista
This is an automated message generated by the Vision Content Management 5ystem-. please do not reply directly to this email.
Caroline Youn
From: Patricia Salvacion
Sent: Monday, May 6, 2019 11:43 AM
To: Kelly Broughton; Caroline Young
Subject: FW: OPPOSITION TO PSYCH HOSPITAL IN ROLLING HILLS RANCH, CHULA VISTA, CA
Sharing.,
From: Amber Jordan Hendren
Sent: Monday, May 06, 201911:16 AM
To: Patricia Salvaclon apsahracion@chulavistaca.gov>
Subject: OPPOSITION TO PSYCH HOSPITAL IN ROLLING HILLS RANCH, CHUtA VISTA, CA
Mnit,'),;Good morning, Ms. Salvacion,
I am a resident, and homeowner in Rolling Hills Ranch, Eastlake, Chula Vista, CA, 91914. It has come to
my attention in recent news stories about a proposed psychiatric hospital being brought to a residential area... namely
MY residential area where I live with my husband and young Son ... in Rolling Hills Ranch.
I am vehemently against such a facility in the centerof a residential neighborhood, nearschools and parks ... and
especially a school bus stopl
IRE Development Is the land owner, Acadia Healthcare (a for-profit company based out of Tennessee), the Chula Vista
Planning Commission and the. Chula Vista City Council are all involved in bringing the Scripps Psychiatric Ward to
Showroom Place, at the end of the cul-de-sac ... from a martial arts school, swim school, Kid Ventures, and other family
friendly businesses,
There are a plethora of concerns that should be obvious about why such a facility should not be in this area: Namely,
proximity to children, increase In sirens with police drop-offs at all hours of the night; traffic, loitering and homelessness
as patients driven In will be released with limited options to get back home. Residents are concerned with the mental
state of these patients.,. many of whom could pose a threat to themselves or others.
Why would the City of Chula Vista city Council and Planning Commission even consider such a terrible proposal?
I hope and pray that you will use all of your political power and energy to put a stop to this proposal, and help to keep
our neighborhood safe for all of it's residents; young and old. There must be other, more suitable areas that are away
from schools and residential neighborhoods for this kind of facility. I am in support of a hospital, and the jobs R brings,,
but this is simply not the appropriate location for a facility like this.
Respectfully,
Concerned citizen and registered voter
Amber Hendren
Rolling Hills Ranch, Eastlake, Chula Vista, California
From: Webmaster
Sent: Friday, May 03,2019 10:07 AM
To: Patricia Salvacion <psalvacion@ichulavistaca.eov>
Subject: City of Chula Vista: Planning Commission . Contact Us
A new entryto a form/survey has been submitted.
Form Name:
Planning Commission - Contact Us
Date & Time:
05/03/20191007 AM
Response th
44
Submbter ID:
62474
IP address:
172.24.96.110
Time to complete:
1 min., 23 sec.
Survey Details
Page 1
'"t please fee➢free"toconlacttis.wjtXahy comm@nts brquestiarisj,y filDng out#fte forrll
First Name �gmadeo " - _-
Last Name Quinto
Emall Address
Comments
Dear Sir/Madam,
I am part of a growinggroup of individuals that object to the building of the planned construction of a Psychiatric hospital at
Showroom PI In Eastlake: Wlthln Just 4 days we have gathered over 100o signatures and the list continues to grow by the hour.
As you should be well aware now, the explosive growth of our petition has garnered media attention from major news outlets,
Including Fox, ABC, and NBC Mthln that period.
While we understand and fullyagrae with the need for such a facility we stronglyfeel that the proposed location is a poor fit
for the area, where It literally opens out to businesses that entirely cater to famllles and children, and is an inconvenient
-- location even for the patients that the facility would serve, taking 2-3 hrs by mass transit to most parts of the city and tolls by
freeway.
...._ Highon the list of our concerns, is that while there havebeen claims and promises ofa safe environment for the patients and
surrounding community, the partner chosen, Acadia, understood to be 80%owner of the facility, does not appear to have a
good enough track record to give us confidence In the credibilityof these claims, Should sufficientsteps not be taken to
ensure public safety upon thevoluntary release of those patlents that may be a danger to others, itis well known amongst
Eastlake residents that law enforcement patrols in the sunounding area are insuf0cient to mitigate that risk.
- We understand that the building of the facility -will bring jobs and much needed Income to the city of Chula Vista, but surely
you could find a more suttable location within the city that Is:
• more central, closer to a major freeway that doesn't require a toll
'Ina region with shorter response times for law enforcement and emergency services
• more accessible by public transportation, especially the trolley system
• closer to the main Scripps hospital
• in an area away from famllyorlented businesses and residences
In speakingwith neighbors, manyhave expressed plans to relocate should this come to pass. Surely such negative pressure on
the most highly appraised properties in Chula Vista would not be to the benefit of the city. Please carefully consider this as
well in your decision.
htt�1/wwwch /o/ol nn' g-commission-board- ber-ion-mllburn-ston-the-bulldina-of-an-nPatient-psvchiatric-
hosoital-next-to-schools-parks-
homes7recruiter 955678663&utm source=share Petltlon&utm medium=facebook&utm campaign=osf combo share InRla
I& tm term= sf combo shareinitl I&re ulted by id=H9797dO6b63-1le9-8h 3-7d 4f d439 b&share bandlt exp=lnitial-
15220650-e -US& have bandit a = 3& tm <o tent=fht45220fi50-en-u %3A T -
https,//fox5sandiego.com/2019/05/01/praposed-behaAoral-heafth facility-cn n - m-easilake-residents/
htt�//w wn6 d' < m/ ws/local/Petltlon-SC rted-by-Neighbors-to-Stop-Construction-of-New-Psychiatrlc-Hosoitat-
509419481.html
htto �//w ,10new cam/news/local-news/chula-vista-residents-fight-batik-against-Proposed-pwchiatrlc- -
hosoital7fbd'd=1wAROltgmv3OoT9FrDwt5w N97Ci041YM41-04D D15AHa Ui5wX6eb3dbAV rg
Caroline Young
From: Patricia Salvaclon
Sent: Monday, May 6, 2019 9:10 AM
To: Kelly Broughton; Caroline Young
Subject: FW: City of Chula Vista: Planning Commission - Contact Us
Sharing...
from: Webmaster
Sent Sunday, May 05, 2019 9:03 AM
To: Patricia Salvation <psalvacion@chulavistacagov>
Subject; City of Chula Vista: Planning Ccmmisslon - Contact Us
A new entry to a form/survey has been submitted.
Form Name:
Planning Commission - Contact Us
Date & Time:
05/05/2019 9:02 AM
Responseg:
45
Submitter IM
62511
IP address:
172,24.%aio
Time to complete:
3 min., 51 sec.
Survey Details
please feet freeo cMdatt us with' anycommgrits orrlue;bprts.byfRling out th (arm below
First Name Monica u
Last Name Nelson
Email Address
Comments
Good mornin&
I have been a resident of Chula Vista for the past 7 plus years (all 7 plus years have been spent in various zipcodes within the
Eastlake/Otay Ranch and Rolling Hili Ranch communities). Over the last 7 years, I have seen a rise m hath crimes and
homelessness.
httos'//www SO s com/news/local-news/otay-ranch,family-upset.ov r vi t video
https:llwww.Ropgle.com/amPtslwww nb endlea om/news/local/CVPD k Ife-r bb v otav r h luven
496469391A 19'3famp=v
https,//www.geogle.cgmlamo/s/www,nboand[ggg,comls/local/St bbina Prompts SWAT St ndoffn Ona Ranch
492380771 html%3famp=v
I have personally witnessed a group of individuals opening packages (which I later learned were stolen from neighbors after
examining the empty boxes left in the shrubs) and then jumping the fence and heading towards section 8 housing, arise In
the number of Individuals begging for money and/or loltering near the Walmart on Eastlake Parkway; and an increase In
tagging in residential as well as commercial areas.
Now, I'm hearing there are plans to build an Inpatlent psychlatric hmialtal in the area. I am adamantly against this! [would
have signed the petition on change.org with the almost 1,400 other residents; however, I do not want my information sold.
http �llwwwchanaeorg/p/planning-commis board- ber-lo -milbum-st thebuild'ngof-an-Inpatient-psychiatric-
hospltaFn ext.to-schools-parks-homes
1 agree with all seven concerns expressed on this petition. The current proposed location is not the place to put this type or
facilityl There Is very little public transportation and therefore patients will have few options once released. In addition the
proposed location is only a mile and a half from Eastlake high school, the largest high school in the area with over 3,000
students and literally across the street from Montevallo (the largest park in Chula Vista) Eastlake middle school as well as
Salt Geek Elementary (which have a combined total of over 2,500 young children). The location is also within a mile of
Thurgood Marshall elementary with over 650 kids and a mile and a half from Arroyo Vista elementary with over 600 children
for a total of almost 7,000 children within a mile and a half mdiusl -
Instead of focusing on increased building In the community, we should look Into ways to make the current residents
safer. We need a police substation in the Eastlake/Otay Ranch area. Chula Vista police station is located 8-11 miles away .
from the Otay Ranch area which houses over 28,000 residents, and the Rolling Hills Ranch community, an area that houses
over 7,500 residents (and is near the proposed hospital site). -
-Please reconsider placing the Inpatient psychiatric hospital in an already saturated community and focus on the residents
and their families by Instead building a police substation east of the 885.
Thankyou,
Monies Nelson
Chula Vista resident
Thank you,
City of Chula Vista
This is an automated message generated by the Vision Content Management System'". Please do not reply d!rectlyto this emall.
Caroline Young
From:
bili stellin
Sent:
Thursday, May 2, 2019 5:32 PM
To:
Caroline Young
Subject:
Showroom Place Psychiatric Facility
Warning:=.
Extemak
EmSil ; Dear Caroline,
I am a resident of Rolling Hills Ranch and I live
approximately one -hundred yards away from Showroom
Place, the proposed location for a new psychiatric hospital. I
am just one of many local residents who have learned of the
proposed building of this facility. I am orae of the five original
members of my neighborhood that have created a
community awareness movement regarding the building of
this facility. Our community is extremely concerned
regarding the .building of this hospital. Over the past three
days, we have grown from five concerned neighbors to over
two hundred activelyinvolved neighbors. We are just getting
started, and by the end of the weekend we estimate
thousands will have learned of the building of this facility.
Our community is comprised of journalists, paramedics,
police officers, firefighters, teachers, nurses, and lawyers, all
actively involved in fighting.the construction of this facility,
many of whom have first hand knowledge of the impact these
facilities can have on a neighborhood. The overwhelmingly
majority of community members we have spoken with are
highly against the building of this facility. We are organized,
and have already gained the attention of news stations, radio
stations, and local newspapers. We have already done
multiple television interviews, and have additional interviews
scheduled with radio stations, television stations, local
newspapers, and other media outlets over the next few days.
Our online petition has received over 700 signatures over the
past 48 hours. Our efforts have attracted the attention of the
team at Scripps Health that is responsible for this project,
and they would like to meet with us.
We are not tyrants, or anti -mental health. We are a simple
collection of families who moved into this area with the idea
that massive hospitals such as this were NOT in our
backyards; that our children could play safely on their
streets and in their parks. The primary partner, Acadia
Healthcare, has a laundry list of complaints against them,
and have been involved in some extremely concerning
lawsuits. This is not the type of company our community
would trust to be associated with a 120 bed psychiatric
facility. The facility is being built directly in the middle of our
neighborhood, a few feet away from a community park, a
school bus stop; multiple schools, and businesses that cater
to young families and children. Our backyards, where our
children play are located less than 100 yards from the
proposed site. We have done a walk through of the
businesses in Showroom Place, and have been in contact
with owners, and regional managers of the businesses and
churches located in that area. Every single person we spoke
to has expressed deep concern over the location of this
facility. They have become active members in our fight. Our
numbers continue to grow daily.
The irresponsible partnership with Acadia Healthcare is
something that our community can not tolerate. The
proximity of Showroom Place to our neighborhood and local
businesses is extremely unsettling to our community
members and local business owners. There are other
available locations, some which are literally just a few blocks
away, and others outside of Chula Vista altogether. Nathan
Fletcher has even proposed a location at 4307 Third Ave in
the Hillcrest area (a county owned property that is within
close proximity to USC San Diego Medical Center) that is
slated to become luxury condominiums. A company such as
Acadia, who has a long history of safety violations, law suits,
allegations of rape, sexual misconduct, child endangerment,
fraud, and elder abuse does not seem like the type of
company we want in the middle of our neighborhood,
directly next to where our children play. The history of this
company, and the imminent dangers they pose to our
community will be brought to light, and is a primary focus of
this community. The history of this company is well.
documented, and it doesn't take much research to identify
that this company is dangerous for our community.
We will be attending city council meetings, city planning
commission meetings, doing neighborhood walks, and
distributing informational fliers to all of Rolling Hills Ranch
and Eastlake. We are an active, educated, and extremely
organized movement. We have made tremendous progress
over the past three days, and as our movement grows we will
only become stronger. We are asking for your assistance in
preventing the building of this hospital on its currently
proposed location. Your participation in this movement, and
any assistance that you could give us would be greatly
appreciated.
I look forward to seeing you at the next few city planning
commission meetings. Please pay attention to the news this
week, as well as local newspapers. You will see that we are
3
taking this situation seriously, and that the voices of an
entire community will be heard)
For your convenience I am linking you our petition and the
first news broadcast from last night. There are more
television interviews airing tonight.
https: / /www.change.org/p /planning-commission-board-
member-Ln-milburn-stop-the-building-of-an-inpatient-
p svchiatric-hospital-next-to- schools-parks-
homes?recruiter=774124759&utm_source=share petition&u
tm medium=facebook&utm_camyai� =psf combo share init
ial&utm term=share petition&recruited_by id=684dc450-
90ca-1le7-9bc4-9764584efcea&share bandit exp=initial-
15220650-en-US8z;share bandit var=v286utm content=fht-
15220650-en-
us%3Av6&fbclid=IwAR2dOXBHOIH IgK9S60kmcpeyxbtWaA
W9terEuhVNtsgMlGdZhiPnQu Q 1pk
https: / /fox5sandiego.com/2019/05/01 /proposed -
b ehavioral-health-facility-concerns-some-eastlake-
residents /?fbclid=IwAR 1YGGdpXQmC4WOzRULDq 5H3PscP
Q10nyVm8X2ZR 9-_d2f9PNzNZbEYXTg
This is an issue that is going to demand your attention.
Sincerely,
William Stellin
Petition Stop the building of an Inpatient Psychiatric Hospital next to schools, parks & h... Page 1 of g
Fol
Stop the building of an Inpatient Psychiatric
Hospital next to schools, parks & homes
r
949 have signed. Let's get to 1,0001
Rebekah Edwards signed this petition
N_L. started this petition to Planning Commission Board Member Jon Milburn and 7 others
Who: IRE Development (land owner), Acadia Healthcare (a for-profit company based out of
Tennessee), the Chula Vista Planning Commission, and the Chula Vista City Council are all involved
in bringing this Inpatient Psychiatric Hospital into a residential neighborhood.
What: The land on Showroom Place is currently in escrow to be sold to Acadia Healthcare to build a
120 -bed inpatient/outpatient Psychiatric Hospital that includes a lockdown ward for patients deemed
to be a danger to themselves and others.
When: According to an article in the San Diego Union -Tribune, the hospital is slated to open in 2023.
Where: The cul-de-sac at the end of Showroom Place in the Eastlake Design District. This is on the
same street as Kid Ventures, Floaties Swim School, Pride Martial Arts, Ninja Factory, Crunch
Fitness, and other family -friendly businesses.
https://www.cbange.org/plplannitkgcomatission-board-member jon-milb=-stop-tho-buildi... 5/3/2019
Petition - Stop the building of an Inpatient Psychiatric Hospital next to schools; parka.& h... Page -2 -of 8
Why: Scripps Mercy Hospital in Hillcrest is demolishing their Psychiatric Ward as part of their effort
to build a new hospital. They plan to transport their patients to the Showroom Place site.
Community Concerns: Community members (including some who actively work with psychiatric
patients) have the following concerns:
1. Poor Partner: Acadia, who will be an 80% owner of this facility, is riddled with lawsuits and
allegations regarding fraud, elder abuse, and child abuse.
2. Poor Release policy: Patients driven in will be released with limited options to get back home.
Residents are concerned with loitering and an increase in homelessness.
3. Location: This hospital would service a large region but is planned for an area with very limited
public transportation. It is miles away from the Scripps Hillcrest hospital and only quickly accessible
via toll mad, which equates to limited access for patients.
4. Proximity to Children: Increase in traffic, loitering, and homelessness create safety concerns for
the many schools, parks, and children in the area.
5. Limited Police: Chula Vista does not have enough police and F,estlake has the fewest patrols
assigned to handle issues arising from the facility or those released.
6. Increase in traffic: Increase in shoos in an otherwise quiet neighborhood.
7. Decrease in local home values: Data reports indicate that homes near similar sites had a decrease
in value.
Other sites must be considered by the Planning Commission Members and City Council.
Start a petition of vour own
start. wtiaov ohour mm
This petition starter stood up and took action Will you do the same?
Start a petition
Updates
Update: Psvohiatric Hospital in Eastlake Next Steps
Thank you for showing your support by signing the petition! We have gathered 800 signatures in
just 4 days and it's all thanks to people like you who care about our community....
Update: Psychiatric Hospital in Eastlake Next Steps
Thank You for showing your support by signing the petition! We have gathered 800 signatures in
lust 4 days and it's all thanks to people like You who care about our Community.
httpsJlwww.change.org/p/planningcommission-board-member-jon-milbum-stop-the-buildi... 5/3/2019
Psychiatric Elopement: using Evidence to
Examine Causative Factors and
Preventative Measures
Dennis Brumbles and Adina Meister
Background: Elopement is a problem In the Inpatient mental health com-
munity. Elopement can have serious and long term effects for the patients
and staff.
O¢Jecdve.' The purposes of this paper pre to present a review of the literature
regarding elopement and to protide reeomm relation forpractice.
Design: rising several databases, a search of the existing literature
.a conducted.
Results. Elopwumloeeuradueto nnumberoffactors,including:psychosoclal
Issues, staflpatlentint<recCion,the patient's attitude toward hooplializatlon,
andthehmentalWness.
Conclusion. it is important to understand why patients seek to elope from
treatment facilities to prevent further occurrences.
O 2013 ELsecler Inc. All rights reserved.
' BACKGROUND
ELOPEMENT, ALSO COMMONLY referred
to as absconding, is the munithorized absence
of a patient floe a meatal health facility without
permission. It bear been identified as a significant
issue by the psychiatric nursing community (Muir -
Cochrane, Mosel, Cerace, Estonian, &-Bowers,
..2011'). Some patients object to being in the hospital,
often on a locked unit. Some, because of the velure
of thea illness, object to tieing offeted medications.
'- Patients who are involuntarily admitted often feel
the need to elope, despite the fact (he courts have
mandated they requite treatment This felt need
for elopement is true even for patients who
.present -voluntarily. ---. -- - _-
Psychiatric patients often display impaitedjudg-
ment, which has the potential to place them in
potentially dangerous situations if they elope from
the hospital. The effect of an elopement can have
long-termnegative consequences onthepadeat, the
staff caring for the patient and the institution
(Bowers, Brennan, Flood, Lipang, Oladapo, 2006;
Bowers, Shnpson, et aL, 2006). There have been
legal judgments where the courts have held
hospitals responsible for the behavior of patients
who haw eloped. For example, in the case of the
Estate of$oflon-v-Brookwood Medical Center, the
family of a new from Alab a successfully won a
judgment of $12 million, after the patient fell and.
died white trying to elope (Legal Eagle Eye
Newsletter, 2007). In another case, a woman from
Australia who was admitted involuntarily to a
Psychiatric facility, Sled suit for breach of duty of
cam, atter she eloped and conceived a child wfiila
away from the hospital. The patient cited that she
was unable to provide physical, emotional, and
financial care for the child In similar cases, breach
of duty of care and breach of patiart's rights have
been cited as the reason for the suit (Cordy, 2012).
Arehloes of ftchtauk Iiufsb g, WI. 27, No. 1 (February), 2013: pp 3-9
Health, Uniurrsgy
:FID.
umblea H5n, RY-
nurse 1,
22 South
Meister)
Elopement is a serious sentinel event and must be
repented to The Joist Commission (2010),
Psychiatric Panama who elope are more likely to
engage in suicidal and homicidal behavior. Elope-
ments can have serious consequences, with one
study reporting a 20-30% suicide rate, w well ms
harm to others (Yasin, Sedaghat, Gbasemi Fre &
Teluanidoca6 2009), A national clinical survey
found that The most common to= of miedde, once
a patient has eloped, an hanging, jumping from e
height, at stepping in front of a moving vehicle
(Hunt, Wisdfubr, Shaw, Appleby & Kapa, 2010).
It is believed that elopemem is related to other
fortes of nun-ectnpliam patient behavior, such as
medication refusal and involvement in violent
Incidences (Bowers, Jarrett, Clark, Kiyimba &
McFarlane, 1999x, 1999b). The consequence of
elopement include physical hann, prolonged namt
ment time, and substantial economic costs (Muir -
Cochrane & Monet, 2008). Recently, O'Driscoll
(2010) suggested that elopement be viewed Be
resistance and that clinicians reframe the patient's
difficult behavior as a display of opposition.
To help one hospital's department of behavioral
health meet its goal of taro elopements, an
evideo<.ed-based practice project was initiated to
examine the topic. The purpose ofthe projectwas to
educatethe staff about the .causative factors fnt
elopement and develop evidence based practice
guidelines to assist stnffinsoming and preventing
them, The goal of this paper, is to highlight the issue
of elopement and serve a6 -a reference for otba
£militias to decrees. elopements. ...
METHODS
Eleemuuic sweeties wen conducted n locate
ompiriad data in English using CINAHL, PubMed
Central, and Atticapirst databases. A search ofthe
key words "psycbdstrio,". "elopement," and
"absconding" produced L29 articles using
CINAHL, 236 articles using PubMed Central, and
62 articles wing AdiclePhst databases for a total of
421 articles. Articles were included in the review if
they wsm published between 1998 and 2011, if
they wen reseamh-based, .and if their sample
population was similar to our psychiatric units in
age and diagnosis. Reviewing the literature, we
attempted to utilize the most frequently cited
spumes on the topic of 'elopement, as well as
articles that represented similar patient populations
to oats. Articles were excluded if they were not
egUMBUS AND MEISTER
written in English, and didnet reflect similarities in
unit demographics and diagnoses. We examined
studies and articlesthat measured the frequency and
etiology for elopement behaviors.
RESULTS
Results of this review will be presented as
follows; understanding why patients elope, ddenti-
fyimg patients moat at risk to elope, understanding
how patients elope, and preventing elopements. It
bears stating that ofteatimes there is not one single,
identifiable reason, why patients elope from psy-
ebtable traits, but often two or more reasons.
Identifying the ammus that patients face while in
the hospital requites accurate assessment skills,
Understanding Why Patients Elope
Thee am many reasons why patients elope from
psychiatric facilities. Bowers of al. (1999a, 1999b)
conducted interviews with a sample of 52 patients
who returned to their wards after elopement.
Common mesons for and themes associated with
elopement are summarized in Table 1.
Understanding Patients Most At Risk
to Elope
In an aftempt to identify patients most at risk to
elope,. Bawore, Jarrett, Clock, Kiyimba and
McFarlane (2000) conducted a prospective study
of patients who had previously eloped from 12
scute Units in dune English National Health
Service Trusts, Comparisons wen made to a
control group matched for diagnosis sad unit size,
using data collected from We records and from
nursing staff. This reseamh constructed a profile of
a patient at high tisk to elope: young, male, single,
and from a disadvantaged group. Meehan, Morri-
son and McDougall (1999), however, concluded
that situational and environtmntal factors son more
likely than patient characteristics to be predictive
of elopement.
Some patients me bond with being in We
hospital. They are accustomed to their daily
routines at home and find that having to change
the pattern of their life to comply with the unit's
routine intolerable. Some find the unit a confining
place with not enough activities. For some, the
stigma of being hospitalized can be overwhelming,
particularly patients for whom this is just one of
numerous hospital admissions (Lick, 2001).
MYCHATIee HOPEMENT
Tads 1. Nabors Paeena Gare br bige"
9oodnn
FxaMeMtl of IN Gifu, patients
Feel tapped aM canMed
Have houseMd respalebYxln tiny bel that meal jai
Fed out off from fdaMs anal family
woMad about the owuaty 0 dwk home and poperty
ImpuNWhy granas abort not being dlxhwaed
Patients a Mase «'orf—ugunibssreus' whin n
r.f.Nm
9
thea hruniuA e". n
Stigma of beton on a p.yMyat,N unit
owikagt wan or the fear
Madkatlon s!de enab
They IW ragleated by abff
nNre to on. di w dc.hd
nkl Ae paean[ wmrn or brought beck? If aa, was trot,
dabr.f.ds
Who on v« do mnaene, to prawns future Nopemena>
Feeling unsafe on the unit has been identified as
another reason patients leave the hospital (Bowers,
Robinson, Flood, Lipang, Oladapo, 2006; Bowers,
Simpson, etal., 2006). Although same patients may
be focused, others sometimes have to deal with
psychotic patients who invade their personal space.
While the psychiatric professional is typically able
to manage this behavior an the unit, it can be very
disconcerting for someone who is constantly in the
proximity of another patient behaving imppmpn-
amly. Staff we often separated from patients by the
nurses' station, which can offer some measure of
false security. Somenmsa9' y7atioos are enclosed or
semi -enclosed in plexiglass; A given patient,
'however, may encountar a pear who may be
Psychotic without the convenience of these pm-
tectom. Mary may feel bullied by some of the
more aggressive patients (Ireland, 2016).
Seine patients feettheneed to be at home to
protect their belongings. Many staff reside in
comforisi secure neighborhoods; however, this
is not always the case for the patients they serve.
Many patients live in subsidized housing or in less
than daimble neighborhoods due to the fact that
their illness, bas robbed them of their ability to
work. Security is often acensi concern for this
population. 'the issues surrounding living in a
lower-socioeiouoonc neighborhood is something
that many staff have never experienced and cannot
fldly, understand (Minerals, McGuire, Williams, &
Wang, 201
One important consideration is that staff and
patients seem to view the hospitalization process
very differtaidy. Staff can sometimes loge perspec
-
five of exactly what an inpatient admission means
m the pullout. Many stafftiewthe unit as a safe and
move environment olemall the patients gather for
a carbonate goal; recovery, Bowers (2003) points
out that this belief is often not shared by the
patients. Some perceive adelay in their discharge or
denial of a leave of absence to be extremely
diecouragiog and containing (Bowers, 2003),
Among the dually diagnosed, the desire to use
substances can be a powerful motivator to elope.
Patients who present wvff substance abuse diagno-
ses or substance -induced mood disorders some
times face the challenge of withdrawal, both
physical and psychological. Many patients feel
that they ere rat getting enough medication or the
right combination of medications to adequately
satisfy rich withdrawal symptoms (Hoxmmk,
Nivlson & Wynn, 2010). Psychological withdrawal
can be even mom devastating than its physiological
counterpart, and yet some sniff lack the knowledge
or espvrience to recognize and understand this
pbouomenon. Alcohol withdrawal bas been bland.
fled be one of the prime reasons patents abscond
from psychiatric units (Andoh, 1999),
Failure to,adequately assess between classes of
polysahmnce withdrawal can have devadtating
effects for both the staff and The patient. Treating
alcohol, benzodiazepine, or opiate willdrawal
demands an Understanding of the effects that each
of these different classes of drugs has on the body.
The clinician most be able to differentiate between
the different types of withdrawal (Stem a al.,
2010). In the case o(polysuhetance use, the clinical
picture may become much cloudier. Some dually,
diagnosed patients may present as demanding,
hostile, or what staff typically describe as "med
sacking" Occasionally, because of thein persistent
negative behavior, some staff may react non-
thetepeutically. The patient may interpret this as
"the staff doesn't like me." It is important to
separate personal feelings from professional te-
sponsibility, and maintain a professional demeanor.
Patients' feeling that "the staff doesn't like me" has
been idenTeed as one significant reason that
patients elope (Bowers of al., 1999a, 1999b).
Conversely, there may be occasions whore
patients take a dislike to, or focus on, a particular
staffmember. Perbapa the staff member baa had to
set limits on a partcular behavior, or perhaps the
staff member reminds then of someone they have
encountered during past hospitalirstions, Nursing
staff tan sometimes be the scapegoat for patients'
perceptions of Inadequacies in hospital acconmao-
detions, food, or other matters for over which they
have little or no control. When feeling attacked, it is
important for the clinician to remain professional
and reassure the patient that they will advocate for
that patient and their needs (Morgan, 2001).
Medication honaomp umce is one of the issues
that psychiatric nurses face on an ongoing basis.
Many patients dislike how the medicatims make
them feel, whether because of aide effects or the
sedating properties of some drugs. Sexual side
effects continue to be an issue with some
psychotropic and anti-depreasact medications. Pa -
theta who are on forded mediconsms arc else ahigh
elopement riak, Foxed to take medications as the
result of a psychiatric medication panel, they are
often very difficult to heat because of their
resistance and their lack ofmslght into their mental
illness (Cartier, 2000.
The influence of the social environment needs to
be acknowledged and examined when attempting to
dernmase the nunberofpatients who elope. Meehan
et al, (1999) has suggested a sortation between
the negative, non-thempeutic attitudes of staff,
elopements and assaultive behaviors by patients,
in other words, staff that display negative attitudes
may be mote likely to become victims of patient
assault and patient's who experience those negative
attitudes may be more likely to abscond.
Nursing is an integral part of the psychiatric
interdisciplinary team, it is important for nurses to
identify and commitments patients who they believe
are ai risk b elope tithe teat of the team. Other
members of 64 team may recognize behaviors that
may be the result of patient dissatisfaction a well.
This mwltidisei Ainary approach appears to be
essential in � reducing the number of potential
elopemeny
ts (flowers or al., 2000)..
'Although most evidence .indicates that elope -
most is a negative incident for patients, thein
families, and staff members, some patients do
appear to benefit, if only temporarily. The patient
may gain a sense of independence and liberation
w a -moult of their nations, and/or a decrease in
paranoia due to no Imager being under conamnt
staffobservation. If the patient has responaibilities
to others, those dependants might gain oompao-
ionship and Support from the absconder who
returns home (Bowers, Jarrett, Clerk, Kiyimba &
McFarlane, 1999a, 1999b). It must be noted
BRUMBLES AND MEISTER
however, that these benefits are far outweighed by
the potentially negative consequences that occur
as, the result of elopement Stewart and Bowers
(2011) point out that one quarter of all tapatient
suicides occur post-alopement.
Understanding How Patients Elope
Meat' patients Successfully elope even aftm staff
bemme aware of their intention to leave, chcum-
ventigg larked doors or special observation. There
are Several reasons why this occurs, Patients often
take advantage of shift change when the staffs
level of vigilance is Reduced. They leave mostly
through the trout door, Bowers at al. (1999a,
1999b) found that most elopements Renamed during
the first few weeks of admission, and mast patients
simply went home and engaged in everyday
activities. Other reported metbods ofescape include
climbing over a high feast or gate, leaving a word
when left unsecured by workmen, stealing keys to
escape, and leaving via a window (Dickens &
Campbell, 2001).
Keys are symbols in psychiatry, and moreover,
they are instruments in a very practical sense as well
(Hazelton, 2006). Some patients feel that locked
doom highlight the Stairs power, making them feet
more depressed and Satious (van der Merwe,
Bowers, from, Simpson & IdaghmuL 2009). Most
keys that are taken appearm be ones that have been
left unattended' A literature search using several
databases did not yield any studies that referred to
staff having keys stolen by patients for the purpose
of elopement
The majoely, of inpatient units one locked wards.
This has both advantages (preventing illegal
substance entry, patient elopement) and disadvan-
tages (paticuts feeling confined eaha work for
staft). Locked wards, however, are also associated
with increased patient aggression, poorer patient
satisfaction with treatment, and more severe
symptoms (van der Memo at al, 2009). Many
patients view locked doom as a symbol of mistrust
by staff (Muir -Cochran, Mosel, at sl., 2011; Muh-
Cochrane, van der Mersin, at al. 2011), while some
Patients stated that the locked doors make them fml
safer, more secure and protected against unwanted
visitors. Others stated that locked doom highlighted
the staffs power and make them fcel anxious and
depressed (van der Memo at al, 2009).
The use of containment methods such as spacial
observation, "dating medication, seclusion, etc.
PSYC TmC ELOPEMENT
can became excessive to the degree that it
daminams practice and draws attention away from
treatment. Finding the right balance between risk
and containment is complicated after staff expert.
ones a serious untoward incident, such as elope
meat (Bowers, Brea um, Flood, Lipang, Oladapo,
2006; Bowen, Simpson, et al„ 2006). Special
observation can be beneficial in providing addi.
fin al staff contact, which may be therapeutically
beneficial. Conversely, it may make patients feel as
if they are being constantly watched, which t rtiw
increases their feeling of incarceration. Although
them is a challenge in achieving a balance between
patient safety and patient mtommy, safety of
patients must mmsin the primary behavioral health
objective (Rout et al., 2010). Bowers at al. (2002)
note that there are higher levels of security
maintained within innercity, psychiatdc wits,
possibly because of their proximity to seam:,, of
danger. It may be the case that rural and semi -urban
hospitals can allow patients more $eedom without
compromising safety. Them investigators con-
ducted a survey of 70 psychiatric unite (urban and
non -urban) and discovowdthat there appeared to be
wide variations in practice (Bowers at aL, 2002).
Researchers have examined the effectiver,, of
different interventions to reduce the rate of
-' elopement, but this work is limited and not
suf&ciently strong enough to guide torten[ acute
psychiatric unit policy in the prevention of
absconding (Bowers, Alexander & Gaskell,
2003). Bowers at al. note the need for stable
staffxg; and good leadership as a necessity when
initiating an anticlopement package.
Preventing Elopements ....
One intervention that has been studied is the
implementation of a self -training package, which
consists of a handbook fm unit managers. The
-handbook comprises a 19 -page guideto Implement-
ing the intarymhons, a 40 page antiabscanding
handbook detailing each intervention and its
rationale, a color mnemonic poster listing au key
intnocotione; and a packet. sized laminated card
containing indications of elopement risk. The six
key poster interventions were: rule clarity through
the use of a signing in and out book, identification
of those at high risk for absconding, targeted
nursing time for those at high risk, careful breaking
of bad news, post -incident debriefing, and multi.
disciplinary review after two elopements, As a
result of the implementation of this training
package, 15 units reported a 25.5% decrease in
elopements (Bowers, Simpson & Alexander, 2005).
There may be a significant link between
elopement and the way in which psychiatric maraca
think and behave (Niiman, Bowers, Dud & Jansen,
2005). Three important factors for the production of
low -conflict, high therapeutic units'rom the positive
appreciation of patients by staff, the ability of the
staff to regulate their own emotions mwerda
patients, and the creation of effective structure
(rules and routines) for unit tifb. The creation of
such a wit may be depmdeut on a number of
factum: the psychiatric philosophy of staff (how
they see the Wrote of mental illness and their role in
caro and heabnent), their moral commitments (e.g.
non-iudgammalism, nmsmg professionalism, hu -
uranium, honesty), their use of cognitive—emotional
selEmanaga sent methods (interpersonal skills),
teamwork (the achievement of cohesion, consis-
tency and mutual support, within and across
disciplinary boundaries), and organisational sup.
port (provision of clinical supervision and lemming
opportunities). Bowers, Bresnan, Flood, Lipaag
and Oladapo (2006b) conclude that low -comfit[
environments am rat achieved through high levels
of containto m, but through better staff altitudes
and working practices.
RECOMMENDATIONS
We have identified consulter ofqueetionsthatmay
help nurses and other marrhers of the interdisciplin-
ary team identify patients at risk to elope (Tables 2
and 3). By add¢ssiug patimes cancers, allowing
the patient to participate fidly in their plan of car, and
utilizing the recovery -based principles, several of
the causative factors that result in elopements can
be decreased or eliminated (Caldwell, Selafani,
Swarbtick & Firm 2010).
Assessing for the risk of elopement should be a
part of the intake process, and risk should be
reassessed periodically throughout the hospitatiza-
tion (Beneeh, 2008). Mental health professionals
have a duty to protect patients by providing them
with the best possible care through integrating
evidenced -based findings into their current pmcflce
(Fisher & Happell, 2009), Too oftm, staff ten
become myopic to their views and a closed system
culture develops. Using evidmced-based principles
oaa make the staff mote open to changes in practice
(Rose & Glass, 2008).
g FR11MBLES Affil MEll
Table 2. ?kaeaq tura/... to Corvi,Lr--0os< napemem
What was me aspaeeme end eked mix of the MR a, den food of
the amen esr.mr
What was the moony of the Maloof
Moat other enwonmamal oro upermional faotm. wens preemar
DID me paten[ have a hlefon N Ohoog Room
"rMaMC amines?
How me, skse ob...Wh. wwa Mae mt nor, Md.
diel' me,.?
M. tyre did the Mrs.. oom? Wed h mar shege.loon?
Were dm" or al Involrm In Mair "a6m to vlaper
Do aro dank fie ddmnwno was oIManW.. or ompMnnetl?
fail Is den securely im n emao A "eMi alopcar
DO the Madam arm. oaftera, aM d nit, dN they feel allenmad
ham named. add farNv?
01d the "tent have aeewsts imkht IM final rmmal
Did the patent meet the man resk mef W for adoo mens?
W>e Mary h ilmury abmitted?
War me "rest pnmk or fearful?
DO me prat l I.ei board?
order Me Han fedi red, ... ad?
DN u" have finammal dill sorry fart W sed to.dander
Was Me marina mond re matom" eemtlw mpumoloodion
at An, palm wnn+he petlmtr
Treahuont programs and nursing models that
milio,oRrovery-based principles not only =wm-
age the verse to treat the patient with dignity and
respect but invite the patient to be an active partner
in their recovery process. Recovery -bided program
values have been identified ae perrsbn orientation,
hope, functioning, involvomonf,.elf-detmmmation,
outcome orientation, support and safety (Fagan -
Pryor, Haber and Rumple, 2009). Participating in
the creation of a recovery -eared culture Can
decrease some of the risk factors for elopement.
RESEARCH IMPLICATIONSAND CONCLUSIONS
Patient elopement ora have several negative
effects on only. staff generally express a sense of
Tere 3. rlwallom fa me MsnWCjpawy Ter. Team
. Rare 9epgiant.
Wbat vin the relatbna id of the treatment ram aka win the
patio.?
old to padam teed u k the ream war Omission to slab mneemet
Wee Me Meant wlm theounh sodatame ~raven
Dm Ne patent have a RM Moseaeaamt W. aM M w were
they Wls adewMely peataE far meek perm
oM Me "dent feel ee if the demo'a wme fine viii, Mrm
deny me fieemingto Rear oenaema?
DN me. Madam haw irym Into them tremnwit pbni Was me
pal low muMtkr
We. three, metal opnum tint the Mahn[ warted addressed?
Was the Aso"t ukkq M W d'echuged?
failure and acknowledge that the event should have
been foreseen sold prevented (Clark, Kiyimba,
Bowers, Jarrett & McFarlane, 1999). Sudden
untoward incidents, such as al and elopement,
can have long-term negative consequences on staff
and their practice for up to 10yems (Bowers,
Brennan, Flood, Lipang, Oladal 2006; Bowers,
Simpson, N al., 2006). In one post -absconding
study, nueaec described feelings of fear, guilt,
responsbility, and anxiety, Involved sniff felt
anxiety because they feared that they were going
W be blamed for the elopement, both by manage
meet and peers, Many won concerned that, as a
rosull, harm was going to coma to the patient; they
felt a ideal of relief when the patient was returned
to the unit safely. It then becomas imperative to
cemorl5te every elopement and understand how any
fdure incidents cum be avoided (powers et al.,
1999x, 19996).
Suggested s.-eas formseamh imlude: =.-=h on
the post-tmlrmatic effects of elopements on staff
(particularly inexperienced voters screamed staff
and the effect of implementation of the recovery
model afoul an elopements.
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