More on Adult Homes
(Column: Ask the Attorney)
At long last public attention is being paid to conditions in adult homes. (See The New York Times, Clifford J. Levy and Sarah Kershaw, March 18, 2001, p. A1 and April 18, 2001, p A1; New York City Voices, Peter D. Beitchman, DSW, June–Aug. 2001, p 14). MFY Legal Services'
Mental Health Law Project has been advocating and litigating on behalf of adult home residents in the five boroughs of New York City since 1987 and is pleased that these issues are finally being exposed.
The Leben Home has most recently received press attention because of both egregious physical conditions and allegations of gross violations of the civil rights of its residents. In June 2000, the New York State Department of Health evacuated an entire floor of the Leben Home after conditions deteriorated to the point of becoming dangerous to the residents' health and safety. Approximately 60 residents were evacuated from the home. Half went to a state psychiatric institution; the other half temporarily moved in with family and friends. These residents were displaced for over two months until the operator remedied the conditions.
Then in October 2000, MFY learned that the Leben Home may have been part of a conspiracy in which a local hospital, a case worker at the home, and two doctors arranged for unnecessary prostate surgery to be performed on 24 unwitting residents of the home, allegedly to collect Medicaid and Medicare monies. A lawsuit against the alleged perpetrators was filed by MFY, Patterson Belknap Webb & Tyler, and Disability Advocates and is pending in federal court. As a result of the lawsuit and the press attention to these outrages, the operator of the Leben Home stepped down as its operator. But there are other pervasive ills in the adult home industry that warrant public attention.
Lack of recreational activity:
Under New York State law, adult homes must provide a program of activities to promote an individual's potential and sense of self-esteem. This is important in adult homes where residents are highly medicated and often isolated from any activities outside the home. Yet what we have seen in most adult homes is appalling. The major form of recreation is a smoking room, without proper ventilation, and with a television droning in the background. The recreation room of one home is in the basement, without windows, consisting of broken exercise machines and a few dirty tables. In many homes, a board may be posted with a host of activities, but those activities rarely take place. Lack of stimulation for residents of adult homes contributes to the sense that adult homes have become a form of reinstitutionalization and not a meaningful form of community living.
Poor environmental conditions:
In 1994 MFY successfully lobbied to have New York State law amended to include a warranty of habitability for adult homes, arguing that an adult home is no less a home than an apartment where a leaseholder is provided a warranty of habitability. Our efforts to do so resulted in demonstrable changes in many homes. Unfortunately, some homes have not complied with the environmental standards required by law. One home, for example, was infested with roaches and mice, had holes in ceilings throughout, lacked heat in the winter and refused to provide enough towels to its residents. It took aggressive advocacy by MFY to get conditions improved. Operators of adult homes have assumed the responsibility to provide supportive housing to the disabled, and should not be permitted to evade this responsibility.
Refusal of adult home operators to re-admit residents after temporary hospitalizations:
Residents of adult homes are periodically hospitalized when their mental health deteriorates. Unfortunately, despite the clear mandate of the law, the operators of the homes use these temporary hospitalizations as a way to get rid of residents they think are "problems" — either because they are behaviorally challenging or active in their Residents Councils or for any one of a host of other reasons. MFY takes each of the individual cases brought to our attention and files a lawsuit on behalf of the resident. Because the law is so clear, we succeed every time in getting an order restoring the resident to the home. Yet the homes continue to engage in this illegal activity, treating residents as if they were pawns in a game that can be moved around at the adult home operator's pleasure.
Time and again we hear that adult home residents who are due retroactive benefits payments or inheritances have no idea where their monies have gone. Upon investigation, it has been our experience that the operator of the home has not informed the resident of receipt of the funds and, in most cases, has also commingled the resident's funds with his/her own finances or with
those of the home. These practices are patently illegal, yet go on all the time.
Until there are more community-based living opportunities available to individuals with mental illness, we must look to adult homes as a housing option. It therefore becomes incumbent upon us, as a community concerned about these issues, to demand that adult homes be decent and humane places to live. We need more funds for advocacy. We need rigorous oversight and enforcement by the Department of Health. We need input from the Office of Mental Health. And we need continued public awareness of the issues.