L. Monica Negrila, MA, LMHC, MHP IKRON of Greater Seattle

Behavioral Health Services

Mental Illness

Mental Health

Behavioral Health

Behavioral Health Services

AddictionSubstance Use Disorder

Behavioral Health

Background

In 2010, the Patient Protection and Affordable Care Act (PPACA—or ACA) charged the U.S. Department of Health and Human Services (HHS) with developing a National Quality Strategy (NQS) to better meet the promise of providing all Americans with access to health care that is safe, effective, and affordable

ACA HHS NQS

NQS Goals:

1. Evidence Based Practices

2. Person-Centered Care3. Coordinated Care

4. Healthy living- communities5. Reduction of adverse events6. Cost reduction

WA State DBHR

The Division of Behavioral Health and Recovery (DBHR) was organized to integrate state-funded services for substance use, mental health and problem gambling.

Goals are to prevent substance use disorders and support holistic, evidence-based, person-centered care that addresses both medical and behavioral health conditions while reducing overall costs.

Behavioral Health

Services

Mental Health Services

Substance Use Services

2016 - Mental Health and Substance Use Treatment integration

SAMHSA’s Definition By behavioral health, SAMHSA refers to mental/emotional well-

being and/or actions that affect wellness.

Behavioral health problems include substance use disorders; alcohol and drug addiction; and serious psychological distress, suicide, and mental disorders. Problems that range from unhealthy stress or subclinical conditions to diagnosable and treatable diseases such as serious mental illnesses and substance use disorders are included.

The phrase “behavioral health” is also used to describe service systems that encompass prevention and promotion of emotional health; prevention of mental and substance use disorders, substance use, and related problems; treatments and services for mental and substance use disorders; and recovery support.

Washington State Behavioral Health Services

DBHR

BHO

BHProviders

BHProviders

BHO

BHProviders

Why Behavioral Health?

Pros:

Inclusive less stigmatized more hopeful

concept (behavior can be changed)

Cons:

Limiting on behavioral change, does not consider environment and other factors

BH Services- classifications Crisis - Acute/Inpatient

Mental Health Care

State Psychiatric Hospitals

Behavioral Health –Residential and Outpatient

Peer Support

Substance Use Disorders- Detox, Inpatient, Residential, Outpatient

Problems of Gambling

Co-occurring Disorders

Tobacco Free

Drug Court & Other related Services

Behavioral Health Integration

The State of Washington has committed to integration of medical care, substance use treatment and mental health care.

Goal to achieve full integration statewide by 2020.

HCA- Health Care Authority

In charge of the physical health and behavioral health integration (Jan. 1 2020)

Various levels of integration across regions in WA state (early adopters, mid-adopters)

Challenges and opportunities

Resources:

http://www.kingcounty.gov/elected/executive/health-human-services-transformation/behavioral-physical-health-integration.aspx#background

https://www.hca.wa.gov/about-hca/healthier-washington/integrated-physical-and-behavioral-health-care

HERO HouseEmployment Programs 

Presented By:

• Kaz Uchimura, BSWEmployment CoordinatorEarl PetersonMember Representative 

Statistical Information

• Unemployment rate in US among people with disabilities was at 10.5% in 2016 to 4.6 % unemployment rate with people with no disabilities. – Bureau of Labor and Statistics 

• Research shows that 60 to 70 percent of people with severe mental illness want to work.– National Alliance of Mental Illness

Unemployment Rates for individuals with mental health challenges can be 

as high as 90%!National Governor’s Association

Independent Employment (IE) Positions maybe full or part time and position belongs to the member. The member will participate in the competitive interview process and there is no formal relationship between the Clubhouse and the employer; however, Clubhouse staff will assist in the member’s career development if needed.

Supported Employment (SE) HERO House helps members to obtain their

jobs. We follow IPS (Individual Placement and Support) model particularly designed for people who are recovering from mental illness.

This model is evidence-based. IPS clients are twice as likely to gain employment (55% v. 28%) and have had better outcomes.

Supported Employment includes:

• Assistancewith applications, resumes & cover letters

• Personalized preparation for interviews and overall career development

• On‐site Job Support & Training

• Continuing Communication with Clients, Employers & Clubhouse/Mental Health Agency via in person meetings, phone and e‐mail

Transitional Employment (TE)

TE jobs are part time, entry level jobs and time limited opportunities that last between 6-9 months to build current resumes and references. TE sites belong to HERO House. In the event that a TE members can NOT perform the required job duties, HERO House provides coverage for the position, even on sick days. Staff will get trained first to learn what the job duties are and train our members at work places; therefore, employers never have to worry about providing a training to our member.

Unmet needs for our members

• Access to public services • Housing• For HERO House, potential members

References

• www.bls.gov/ (Bureau of Labor)• www.nami.org (National Alliance on Mental Illness)

• www.nga.org (National Governor Associasion)

• HERO House: www.herohouse.org

IKRON OFGREATER SEATTLE

A Continuum of Behavioral Health Services…

IKRON –In Pictures

IKRON’S MISSION:

To assist adults and youth who use IKRON’s services to build self-confidence, attain greater self-sufficiency, lead more meaningful and fulfilling lives, and to obtain and maintain satisfying employment.

PHILOSOPHY TO SERVICES:

Everyone has the potential to live a fulfilling and independent life regardless of barriers

Uniqueness consists in: 1. Strength-based approach to services; School of life versus

educational background

2. Positive home-like environment

3. View of participant in services – equal partners; team approach

DBHR CERTIFIED SERVICES:

Currently providing: In the future:

Employment Services Mental health Case Management

(health insurance, community resources)

Individual and Group Counseling Psychiatric Services-Medication Substance Use Disorder Level I Substance Use Disorder Level II Peer Support Services DUI Assessments

Primary Care

Current Funding Sources

DVR

KC

WDC

City of Kirk. andIss.Other

CITY OF KIRKLAND FUNDING

Opportunities met: Challenges:

Fills in the gaps in areas where other funding is not available (e.g. DVR, lack of health insurance, etc.)

Increases opportunities for local residents

Increased awareness and prevention

Local systems, not local residents (e.g. Probation)

Services available, limited direct support (transportation, direct funding)

System challenges (housing)

STAY CONNECTED… PRICELESS!

What money can’t buy:

Volunteers – services, mentoring, development

Serving on the Board of Trustees

Becoming a Community Partner: vocational assessments, career exploration, informational interviews, consultation

THANK YOU!

IKRON of Greater Seattle3805 108th Ave NE, Ste. #204

Bellevue, WA-98004

(425) 242-1713

mnegrila@ikron.org

www.seattle.ikron.org

THE IKRON TEAM…

HOUSING STRATEGY ADVISORY GROUP

STRATEGIES  FOR  ASSISTANCE  BY  CITIES

Overall Housing Strategies

CITY STRATEGIES/TOOLSLAND USE REGULATIONS

INDIRECT ASSISTANCE◦ DENSITY BONUS/ HEIGHT INCREASE

DIRECT ASSISTANCE

CITY STRATEGIES: Land Use Regulations:

Supply Diversity  and Relative Affordability

◦MIXED USE◦ SENIOR HOUSING REGULATIONS◦ PUD/ DENSITY AVERAGING◦ACCESSORY DWELLING UNITS◦ COTTAGE HOUSING◦ ZERO‐LOT LINE/DUPLEX

Micro apartments in Ped Friendly / Transit Rich

5

What is a ‘micro unit’?o Limited  Size

o Independent units(bath, cooking facility)

o Typically some common area(May include larger kitchen)

o Reduced Parking

o May bundle costs (e.g. utilities)

o Relatively affordable

SENIOR HOUSING REGULATIONS

Riverside Landing: Bothell

Brandenwood: Bellevue

ACCESSORY DWELLING UNITS(ADU’s)

COTTAGE HOUSINGConover Commons (Redmond)

Danielson Grove / Kirkland Bungalow Cottages (Kirkland)

CITY STRATEGIES/TOOLS: Land Use Incentives

Within the market / explicit affordability / moderate‐low cost

LAND USE INCENTIVES

◦ DENSITY BONUSES

◦ REDUCED PARKIMG

◦ FEE WAIVERS 

ZONING/REGULATORY INCENTIVES 

Lakeview Commons (Kirkland)

Kelsey Lane (Bellevue)

Pacific Inn (Bellevue) – Reduced Parking

Land Use IncentivesEast King County

11

Increased significantly in last few years

Helps  offset decrease of moderate priced market housing.

Create broader mix of moderate priced housing:         ownership /   more 2+ bdrm

CITY STRATEGIES/TOOLSDirect Assistance

Low – Very Low Cost / Range of Needs / Throughout East King County / ‘Opportunity’ 

◦ FUNDING ASSISTANCE◦ General Funds / CDBG / Other◦ Grants / Loans

◦ FEE WAIVERS

◦ SURPLUS LAND

East King County Trust Fund

A range of incomes and householdsGeographic balance over timeOver $47 million of city resources:◦ General funds (~40%), ◦ Federal CDBG funds (~20%), and 

◦ ‘Other’ (e.g. land,  fee waivers, repayments) (~40%).

Agencies leveraged almost $450 million. 

PROJECTS ASSISTED 1993 ‐ 2016

HOUSING TYPE# UNITS / BEDS FUNDING*

Family 2,196 $25,882,324

Senior 669 $10,478,642

Homeless 341 $8,169,739

Special Needs 163 $3,394,582

TOTAL 3,369 $47,925,286* Includes funding, land donations, fee waivers

ARCH Sphere of Influence‘East’ King County

Kenmore WoodinvilleBothell

CITY PERSPECTIVEValue of working collectively:

Challenge of securing opportunities in high market area◦ Can pursue best opportunities where ever located◦ Create geographic and housing balance over time. 

Allows all cities, regardless of size, to provide assistance◦ Smaller cities hard to have impact

Cooperation with other cities –◦ Leverage other funding◦ Learn from each other◦ Efficiency in administration

Housing markets/needs not defined by city boundaries

PROVIDER’S PERSPECTIVE

Stable Funding Leads to Stable OrganizationsAbility to grow and mature

Better developers and owners

Result is more affordable housing

Paving the WayPlanning

Community Receptiveness

Creating opportunity: Surplus/underutilized public land

Kirkland

Bellevue

Creating opportunity: Faith Properties

Creating opportunity: Fee Waivers (Permit  / Impact Fees)

Village at Overlake KCHA  (Redmond)

SPECIAL NEEDS HOUSING

(Friends of Youth): Kirkland

DD Group Home

(Residence East)Bellevue

HOMELESS HOUSINGFamily Village (YWCA)

Avondale Park (Hopelink / FOY / CCS)

Petter Court (Attain) Kirkland

HOMELESS HOUSING

HopeLink Place Bellevue

SENIOR HOUSING

Washington Court

(Assisted Living):

Bellevue

Cambridge Court(Independent Living)

Bellevue

FAMILY RENTAL

Highland Garden (St. Andrews) - Klahanie

Easternwood (LATCH) ‐ Bothell

FAMILY RENTALPreservation

Chalet (Imagine Housing) - Bellevue

Plum Court (DASH) ‐ Kirkland

SECTION 8 PRESERVATION

Wildwood (DASH) : Bellevue

Ellsworth House Imagine Housing (Mercer Is.)

FAMILY OWNERSHIP

Newcastle Townhomes (Habitat) - Newcastle

SUMMARYKeys to Success

Reduce builder risk◦ Technical studies / Permit process / market

Reduce costs◦ Land / Permits / subsidy

Minimize Pre‐Development Cash Flow◦ Land payment timing / Pay for technical studies

PUTTING IT ALL TOGETHERCITIES ACTING AS A CATALYST FOR AFFORDABLE HOUSING

◦ Combining Strategies

◦ Partnering with Private and Community Groups

◦ Understanding / Reducing ‘RISK’

PUTTING IT ALL TOGETHERGreenbrier Heights - Woodinville

• senior, family rental/ownership•County surplus land•Narrow Roads•Cottages

•Affordable Housing Bonus•Wetland Density Transfer•City Fee Waivers• Funding from 3 cities, County, State

PUTTING IT ALL TOGETHERVillage at Overlake - Redmond

• Mixed use: Housing above Park n Ride

•Housing emphasis area

•City fee waivers

• Funding: 3 cities, County, State

PUTTING IT ALL TOGETHER

Riverside Landing - Bothell

• Senior Rental

•Surplus City/County land 

•Senior overlay zoning

• Funding from 3 cities, County, State 

HOMECHOICE  WAY

Program to allow communities to explore creating a small neighborhood that maintains the traditional design character and quality of single family neighborhoods, while also offering a range of ownership housing choices.

DESIGNOverall Concept

Traditional Subdivision

12 Lots/12 Homes

HomeChoice Way

12 Lots/24 Homes

DESIGNPotential Forms of Housing

Single Family Home

DESIGNPotential Forms of Housing

Duplex (on a corner lot)

DESIGNPotential Forms of Housing

Multi‐unit home designed to look like single family home

Multi‐Unit Home

DESIGNPotential Forms of Housing

Detached Cottages

Cottage HousingThird Street Cottages (Langley)

DESIGNOverall Concept

ISSUES FACING SUBURBSLack of Understanding◦ Deal with myths◦ Put a face on it

Economics

Newer Land Use Patterns

Government Structure◦ Resources (financial and staff) to address complex issue◦ No history / experience◦ Political Dynamics

MIXED USE HOUSING

Lionsgate : Redmond

Kitsilano

Vancouver, B.C.

PUD/DENSITY AVERAGING

Cambridge Senior Apts: Bellevue

Yarrow Point PUD

Kirkland

ZERO‐LOT LINE/DUPLEX

‘Community Development’ aspect of affordable housing

Marry together more philosophical aspects of working on affordable housing, with the technical aspects (real estate economics); the data driven aspects, and specific strategies.  

2017 Housing Strategy Plan UpdateHuman Services Commission

October 24, 2017

What is the Housing Strategy Plan?• A discrete list of tasks identified to implement the Housing goals

and policies in the Comprehensive Plan• City has had a Housing Strategy Plan since 1st Comprehensive

Plan after GMA• Last updated in 2007 • Comprehensive Plan updated in 2015

Housing Strategy Plan Outcomes• Since 2010

– Inclusionary Housing– Zoning and Design Regulations

for South Kirkland TOD– Advocated for state legislation to

exempt impact fees– Implemented impact fee

exemptions– Allowed impact fee deferrals– Adopted Section 8

nondiscrimination requirements

Housing Strategy Plan Outcomes– Became a CDBG Joint

Agreement City– Increased annual ARCH Housing

Trust Fund contributions (local projects funded: FOY campus, South Kirkland Park & Ride, Athene, DD Group Home)

– Updated Comprehensive Plan– Partnered with ARCH and others

to begin siting process for shelter

Inclusionary Housing

Affordable Units Ownership Rental Payment Total

Inclusionary Requirements(Completed or Under Const.)

13 4 8 25

MFTE(Completed)

23 23

South Kirkland TOD(Completed)

58 58

Permitting 206

Pre-permitting 131

Total 443

Housing Strategy Plan Update Process• Goal is to create a work program for housing issues• Engage a cross section of the community as an advisory group to create the

strategy plan– Neighborhood associations (through KAN)– Small business– Large business– Faith community– School community– Planning Commission– Houghton Community Council– Human Services Commission– Senior Council

Housing Strategy Plan Update Process• Also engage the broader community during the process to:

– Educate– Increase awareness– Build a base of support for future actions

Housing Goals

Housing Strategy Plan Update Process• 9 meetings over 8 months, so

far– 6 meetings providing

background to group, including input from housing stakeholders

– 3 meetings identifying and sorting strategies

Housing Strategy Plan Update Process• Sample Strategies

– Address the “Missing Middle”• Promote walkability within neighborhoods• Allow limited commercial development • Increase pocket parks• Allow smaller lots and more diverse housing

– Increase supply of small, single story homes– Encourage more ADU construction and use– Advocate for reform to condominium liability laws– Public funding for affordable housing

Housing Strategy Plan Update Process• Outreach to broader community

– 6 Focus Groups • Seniors• Students• Downtown Merchants• English Language Learners• Real Estate• Safe Parking

Housing Strategy Plan Update Process• Outreach, continued

– On-line survey – Available for 1 month– Advertised through press releases and social media– 1,468 responses

Housing Strategy Plan Update Process – Survey

7%

13%

15%

22%

24%

33%

20%

47%

44%

4%

12%

11%

21%

20%

24%

46%

29%

36%

89%

76%

74%

58%

56%

43%

33%

24%

19%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Housing options that are affordable are hard to come by.

Relatively affordable housing options are being demolished.

Families, particularly young families, have limited housing options in Kirkland.

Kirkland lacks small housing alternatives, such as ”micro‐ housing,” tiny houses, cottages and small …

Overall, Kirkland does not have an adequate supply of housing.

Most housing options have easy access to public transit.

Kirkland lacks specialized senior housing options.

Seniors are able to age in their existing home.

Homes that accommodate extended families are plentiful.

How would you rate the following statements for Kirkland today?

Disagree Neutral Agree

Housing Strategy Plan Update Process – Survey

23%

20%

23%

30%

29%

37%

31%

26%

31%

25%

19%

46%

11%

17%

21%

14%

16%

9%

16%

24%

20%

29%

38%

13%

66%

63%

56%

56%

54%

54%

53%

50%

50%

46%

43%

41%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

There is a range of housing options for households at all stages of life.

There are opportunities to “age in place,” either in your current home or housing specifically for seniors.

Higher density housing opportunities exist close to good transit service.

New housing fits in with and preserves the character of the existing community.

Neighborhoods are stabilized by preserving existing housing and maintaining its relative affordability.

There is housing available for local employees earning $25,000 to $60,000 each year.

Home ownership opportunities are increased for a wider range of households.

There is more single family housing available.

There are opportunities for young households, including students or entry level workers, through individual or…

New housing provides a diversity of architecture.

There is housing available for adults with special needs.

There is a range of housing affordable to a wide range of incomes, including lower incomes (less than $25,000).

Which of these statements are successful outcomes for Kirkland in the next 20 years?

Disagree Neutral Agree

Housing Strategy Plan Update Process• Outreach, continued

– Community Workshop (December 5th or 6th)– Questions for workshop:

• Are these the right strategies to address citizen’s concerns?• If not, what ideas do you have?• Are there areas that we can build on or go further with?• What questions do you have or think others will have?

Housing Strategy Plan Update Process• Next Steps

– Workshop– Group prepares recommendation– Check in with Planning Commission– Final recommendation to City Council – 1st Quarter 2018

• Questions or comments?