You Need Clinical Acumen to Serve the Mentally Ill

Group Home Chronicles


While more and more small group homes are now serving the medically fragile elderly, the catastrophically injured and others, services to those with mental illness and developmental limitations remains.  We need these homes that often use publicly allocated funds – typically from Medicaid budgets – to provide structured, residential services to this most fragile population.

Now, even unlicensed homes are being used to help provide a stable environment, even for those with a dual diagnosis.  However, these homes are still expected to adhere to certain protocols including management of a residential program that is responsive to individual resident needs and that operates in a person-centered way.

Even when a home is approaching a community mental health agency with the goal of entering a business relationship, these agencies expect that communication to include certain items including:

1. Contact application
2. Clinical Narrative: A thoroughly researched item explaining how you will respond with clinical competence to the needs of those you indicate you want to serve
3. Itemization of Need: Knowing to what extent the same or similar services are being provided in the same zip code of where you plan to operate, isolate how your response to resident needs will differ and/or why there exists a shortage of qualified providers where you plan to operate


Where providers must be truly careful is taking a “landlord-tenant” approach to these group living arrangements.  While there are room and board residency programs in differing places with differing zoning and other requirements, these are typically for high functioning people who do not require such a clinical approach.  For others, a more structured set of circumstances is required which demonstrates the clinical competence is present.

Adult day programs – whether residential or commercial – in many states are now being subjected to the same requirements.

Regardless of the regulatory requirements, group living owners need to demonstrate that your approach is one of standards; or you will find earnings from your highly spiritual work will be as fleeting as the wind!

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