In Massachusetts there is growing resistance to locating behavioral health (or similar) programs in many communities. Yet despite opening eight new sites in the past five years (six of them residential), Riverside Community Care has experienced remarkably little resistance from communities and local politicians. I believe our model for reaching out to and educating the community is one of the reasons, and I believe it can help other providers in these situations.
Over the past few years, dozens of local newspaper stories have chronicled the battles taking place in Massachusetts cities and towns with proposed program sites. Public hearings have been increasingly crowded and raucous. State legislators and local leaders have raised questions about facilities/programs’ locations and have tried to restrict their placement. Providers’ reputations have been attacked as these battles heat up.
Some neighbors and politicians have been trying to block new programs through intimidation (maps to agency CEOs’ homes have been published) or by seeking to change laws and regulations. They have been challenging providers’ compliance with existing laws and demanding that alternate sites be found.
This “not in my backyard” attitude has been with our industry since the early days of deinstitutionalization, and this situation is not unique to Massachusetts. The pressure on providers appears to be growing because of at least two overriding factors:
Communities are increasingly fearful about who is going to be using services. Long-standing concerns about the relationship between violence and the people we serve continue to cause providers problems. Specific fears about sex offenders moving into a neighborhood through our programs appear to be increasing the community's anxiety to even higher levels.
Providers (and public payers) have failed to develop a consistent, thoughtful, legally sound model for dealing with these issues. In many cases, providers do not even know the applicable laws and spend more time on less volatile issues than on preparing for their interaction with new neighbors.
As the president/CEO of a large not-for-profit organization for nearly 25 years, I have spent most of my career thinking about the location of services and have met with hundreds of people as we have moved into their neighborhoods. Based on this experience, we have developed a model for working with and educating neighbors and other interested parties.
After obtaining site control, we introduce ourselves by sending letters to neighbors, the police, and politicians, inviting them to attend a meeting and explaining who we are and what we do in their community. We have found that the more vested we are in a community, the easier it is to gain community acceptance. We mail the letter after site control is established and, ideally, before anyone moves in. Before the meeting, we take calls but try to steer questions to the meeting.
We hold the meeting at the site (if possible). Food and drinks are provided, and we encourage informal discussion before and after the meeting. Visitors have the opportunity to walk the property without an escort. We have found that neighbors actually look under beds or in closets for hidden equipment and/or restraints and are more comfortable doing this without an escort.
During the meeting the lead presenter, versed in key laws and regulations, describes the value of our services and is sympathetic to the community's concerns. We cite our experience and the work we do in the community, including our services’ breadth and depth and how we assess referrals, establish reasonable staffing patterns, and adjust staffing and other supports. The lead presenter introduces the site manager and other key people.
Presenters make it clear that they understand that their neighbors are worried about violence, property values, and many other issues. We provide basic education and statistics in an easy-to-understand format to help dispel myths. We don’t ask the community to simply trust us, explaining that our good neighbor behavior will make them feel more comfortable, and that we hope for the same from them.
We explain the limits of what we can share and why, including why we gained site control before contacting neighbors or other public officials. This includes a simple overview of the Fair Housing Act (if relevant) and healthcare privacy laws, which we relate to their own desire for privacy. We explain where funding comes from and invite funding sources to the meeting.
We encourage honest discussion and try to answer any questions, requesting that the tone be respectful and explaining that we voluntarily are holding a meeting to begin a dialogue. We respond to the now routine sex offender question honestly. For example, we explain that it is possible a sex offender could end up living in one of our residential facilities, but this is preferable to him living in the community without services. We answer every question honestly and make clear that we will make only commitments we are sure we can keep.
In addition, we develop a contract or agreement with our neighbors. This agreement focuses on clear expectations and timetables. A model for ongoing communication is established (whether through meetings, e-mail, or calls to selected neighbors). We distribute the phone numbers of the site manager, his/her supervisor, and the CEO, and tell neighbors how to reach someone 24/7.