Unregulated homes put disabled and elderly at risk
Unlicensed barding homes can be dirty, dangerous and leave vulnerable residents open to exploitation.
By Joshunda Sanders and Eric Dexheimer
Sunday, August 30, 2009
Last month, Austin police arrested Tommie Yvette McKinney, saying she'd opened a credit account at a local electronics store in the name of another woman and racked up $1,100 in charges. The alleged victim, who is mentally disabled, was renting a room from McKinney at the time.
It wasn't McKinney's first brush with the law. Court records show she was arrested in 1989 for taking another person's food stamps and public assistance checks. A 2002 arrest affidavit out of Travis County reported, "McKinney's criminal history shows she had 14 theft convictions."
State criminal justice records show she has been sent to prison three separate times on felony theft convictions in three different counties. She filed for personal bankruptcy in 2004.
McKinney, 46, has operated several boarding homes in Northeast Austin in recent years. Charging about $500 per person per month for meals and a bed, the facilities house a dozen or more tenants in single-family homes, which McKinney typically leases from owners who live out of town. Most of her tenants are disabled or elderly and can afford no other place to live.
"It's a difficult clientele," McKinney said in an interview with the American-Statesman this spring, before her arrest. "But for me, it's a fun business. It's hard. But it's a God thing."
McKinney has not been convicted of the latest charge; her next court date is in two weeks. She did not return calls after her arrest. Acquaintances said she had turned away from her criminal past and was running decent businesses.
But housing and mental health advocates say she highlights a yawning regulatory gap in how communities care for some of their most vulnerable residents. While their tenants often have little or no income other than public support payments, such as Social Security and food stamps, boarding homes such as McKinney's operate largely out of sight, unlicensed and unregulated by any state or local agency.
That separates boarding home operators from nurses, massage therapists, locksmiths or any of the dozens of professions whose government oversight limitsemployment by those with a criminal history to protect the public. "It's unbelievable that someone like her could be in this business," said Robert Dole, who as program manager of the Austin Travis County Mental Health Mental Retardation Center's Assertive Community Treatment team keeps track of the agency's clients living in the community.
This spring, after years of debating how to tackle the problem, the Texas Legislature passed a law giving individual cities a framework to license and regulate boarding homes. There is no money attached to the law, however, and Austin officials said they are unsure if they will participate. While the City Council's public health and human services subcommittee has discussed the new legislation, Austin "has not yet indicated whether it will change current regulations about boarding houses," said Jennifer Herber, a spokeswoman for the city's Solid Waste Services and Code Compliance department.
Many boarding homes provide decent and dignified housing at a affordable cost to challenging clients. "You're not going to find a bunch of angels and saints," said Rouzan Barton, whose family ran JJ's Care Home in East Austin for decades before recently converting the facility into a motel.
Some, however, don't. With no one checking regularly on conditions, the homes can be unsanitary. "The general consensus is that some people will not send their dogs to go live in a board and care," said Marilyn Hartman, a spokeswoman with the Austin chapter of the National Alliance on Mental Illness.
They also can be dangerous. In February, Austin police arrested Calvin Shepard, charging him with raping a woman who lived in a Northeast Austin boarding home he operated. The woman had run out of her pain medication and, according to the arrest affidavit, Shepard told her he would give her some if she had sex with him. When she refused, Shepard raped her, the affidavit said. His next court hearing is scheduled for late September.
The homes exact a public cost, as well. Active in the University Hills Neighborhood Association in Northeast Austin, Joan Bartz has tried to get regulators to pay attention to the drain placed on the city's police, fire and ambulance services by what she calls "rogue homes," including one until recently located across the street. "At times our cove resembled a staging area for some emergency," she said.
Since 2008, public records show that Austin police have received 622 calls for service to five boarding home locations McKinney said she had managed. "People don't realize the magnitude of the problem," said Bartz.
How many are there?
Because boarding homes are unlicensed, there is no way of knowing precisely how many there are. Neighborhood activists complain that the homes often appear and disappear without notice.
"They pop up in the middle of the night," said Dwayne Lofton of the Pecan Springs-Springdale Neighborhood Association. "They'll move in beds and tables. Then they'll start moving in people one by one. Suddenly, there are 20 strange people in the neighborhood."
Some estimates have placed the number of boarding homes across the state as high as several thousand. A report released in January in anticipation of the Legislative session counted about 850 of the facilities throughout Texas, although it conceded that the number was probably higher.
Most were concentrated in large cities; the Austin area had 92, the report found. City officials said many of those appeared to be in and around the northeast part of the city.
Advocates for elderly and mentally ill people say one reason the system has been permitted to exist with no oversight is that boarding homes provide cheap housing that government can't, or won't. The January report found that residents of boarding homes were among the state's neediest. About a third of the residents had some form of mental illness; another third were elderly.
They were also among the state's poorest. "Of the boarding homes we surveyed, the residents' incomes were, on average, under $650 per month, or less than $7,800 per year," the report concluded.
That's the amount of money people with disabilities collect in federal income payments though Supplemental Security Insurance, which for many amounts to their only income. Unlike many other states, Texas, which ranks 49th in spending on people with mental illness, according to the National Alliance on Mental Illness, does not add to that stipend with state support.
After rent, not much is left over for food and other necessities. While Texans pay an average of 40 percent of their income for housing, disabled state residents pay an average of 97 percent, according to a study published in April by a national advocacy group.
The recession has exacerbated the problem, as cash-strapped residents seeking cheaper living accommodations downsized to apartments once used by Austin's poorer residents. "It's a reverse trickle-down effect," said Margaret Shaw, director of Neighborhood Housing and Community Development for the city.
Those with serious mental and physical illness have a particularly hard time finding a place to live. In 2007, Barton said, JJ's took in a man just released from a hospital who had no place else to go. Weighing less than 100 pounds, he died several days later.
Patients' length of stay at residential psychiatric facilities such as the Austin State Hospital has dropped dramatically from the 1990s, meaning that those who once relied on such facilities for living space are back in the community sooner, seeking a place to live on their own.
Though they may have serious mental disabilities, most adults with psychiatric diagnoses are not the responsibility of the state and thus can make their own decisions about where to live. "They make their own choices," said David Evans, Austin Travis County MHMR's executive director. Besides, he added, "We have 5,000 adults on our case management. We don't have a role to actively review the quality of their housing or inspect it."
That can leave clients at the mercy of less-than-caring managers. Last month, Shannette Roberts, who worked at a group home on Leafield Drive in South Austin, admitted opening a utility account using the name and Social Security number of a resident with severe mental disabilities, a third-degree felony. She was sentenced to three years of probation.
Despite their promise to provide food, some boarding home managers require residents to supply their own, often by loading them into a van and driving to food banks to forage for the house, according to residents and mental health workers. Managers "find it profitable because they cut corners," said Kenneth Placke, director of behavioral health services for Austin Travis County MHMR.
Tenants are slow to complain and reluctant to leave because there are few other options. "On a given day there may not be any vacancy," Evans said. "Therefore, the choice is homeless or a room and board home. You're being forced into an impossible choice. It's the best of the worst situation."
Now 51, Susan Marion was diagnosed with paranoid schizophrenia 30 years ago. She was first admitted to Austin State Hospital in 1981. Medical records show she has been in and out of psychiatric hospitals two dozen times since then.
Once discharged, she typically ends up in a boarding home. In recent months, she has shuttled between a half-dozen of them, including several owned by McKinney. "I move around," she said.
Marion said she pays about $500 a month in rent from her $650 federal assistance check and turns over most of her $90 in monthly food stamps to the landlord. She said she shares the single-family homes with 12 to 14 others, many of whom use illegal drugs.
At one home last year, the electricity was shut off, she said. In January, Marion added, she was locked out of her home in the middle of the night.
But she also conceded she's not the easiest person to live with. A former crack user with diabetes, Marion must take nine pills a day, several for her psychiatric symptoms, which she carries in a plastic Dollar store bag tied in a bow and stuffed into a weathered backpack. She said she often is forced to leave the boarding homes when her hallucinations gets too vivid and the homes tire of her calling 911.
"The voices get too deep," she said. "I call every night. I get possessed."
Between the laws
This year's legislative report found the state's dependence on boarding homes to shelter people with disabilities put it in an awkward position: "Although these establishments are a de facto part of the state's housing options for the seriously mentally ill and for aged individuals, they are not regulated by the state."
The facilities fall between a latticework of laws. While the federal government has the authority to monitor and regulate boarding homes when landlords accept SSI payments from tenants, it almost never does so because cutting off the money would most harm the clients who depend on it for living expenses, according to mental health advocates and the legislative report.
Cities have used local zoning ordinances unevenly to police boarding homes. El Paso requires "lodginghouses" to get a city license, pay an annual fee and meet basic hygiene standards. Those that don't can be fined.
While Austin has rules permitting the city to license and regulate boarding homes according to location and number of residents, the city has limited its application primarily to student housing, fearing it will run afoul of a 1995 U.S. Supreme Court ruling making it impermissible to limit the location of group homes serving disabled clients. As a result, city inspectors respond only to complaints of unsafe living conditions, said Jill Mayfield, a spokeswoman for the city's Solid Waste Services Department, which enforces code violations.
State laws say a facility that offers rooms and meals and no other services does not have to be licensed. The state Department of Aging and Disability Services, which regulates assisted living facilities and nursing homes, will send an inspector to a boarding home only if it receives a complaint.
If the home is found to be violating the law, the agency can order the operator to get a license or stop providing prohibited services. If an agreement can't be reached, the case is referred to the attorney general for prosecution. That happened 13 times statewide last year and nine in 2007.
Yet even once they are found deficient, facilities quickly drop off regulators' radar. In 1999, JJ's was ordered to stop providing personal care services to its residents. But the state didn't check in again for eight years, until it received a complaint that the resident just released from the hospital had been found dead. In 2007, the disability services department removed all of JJ's residents.
Advocates say the system establishes a dangerous dynamic: Clients who most need assistance often can't afford the more expensive licensed assisted living facilities that provide it and so end up at unlicensed boarding homes — which by law can offer no help, even with the most basic tasks, such as handling their many medications.
"Medicine bottles were everywhere; it was just a free-for-all," said Carson Palmer, who last year was forced to live in a boarding home in Northeast Austin after a bad car accident left him unable to work. His mattress had blood stains, he recalled; cockroaches climbed over him at night.
Typically low-budget operations, boarding homes often are staffed by a single manager for a dozen or more residents. When their behavior spirals out of control, taxpayers pay for expensive emergency help. Two boarding homes McKinney said she managed, on Loyola Lane and Meadowood Boulevard, have racked up more than 320 welfare checks, suicide threats, disturbances and other police calls since the beginning of last year, according to police records.
After seeing the flashing lights swirling around her neighborhood boarding homes, Bartz searched city records to calculate how much each emergency call cost and then multiplied it by the number of calls to area boarding homes. In 2008, she estimated, it cost the City of Austin about $1.8 million for emergency crews to respond to the eight facilities in her neighborhood. The city didn't dispute Bartz's figures. However, a spokeswoman said the issue was less about the cost of individual calls than about how resources are allocated.
Efforts to rein in even obviously illegal homes — those that provide services to residents without being licensed or abuse tenants — can be unsatisfying. In 2007, a Travis County court ordered the owner of an Austin boarding home called Celebrate Life to pay nearly $100,000 in fines and legal costs — a full three years after the facility was ordered closed when investigators found an elderly woman with dementia "routinely" locked in a room with boarded-up windows. Though the facility was put out of business, none of the money was ever collected, according to the attorney general's office.
A legal compromise
State legislators have tried to pass laws providing oversight of the homes. In 2005, lawmakers created a task force to study boarding homes but concluded only that simply registering the facilities wouldn't address the problem. In 2007, Rep. Jose Menendez, D-San Antonio, sponsored a bill requiring the Department of Aging and Disability Services to license and inspect the homes. But the proposal died when the agency said it would cost tens of millions of dollars to implement such a program.
"I just can't tell you how many years we have worked on this specific topic," said Kathy Schoeneberg, executive director of the Texas Organization of Residential Care Homes. "We feel like the mental health and mental retardation patients, someone has got to watch them and keep them safe."
This year, legislators settled on a compromise: A new law gives local governments a structure to license and inspect the homes, but only if they want to. Like day care centers, boarding homes in cities that choose to participate would have to meet certain hygiene and safety standards and would be subject to inspections and penalties.
"Rather than creating a new bureaucracy, I thought if cities and counties would like to have the authority to create oversight for these home and regulate them, now they can," Menendez said. "Now local communities have this to protect our most vulnerable citizens from being taken advantage of."
The state Health and Human Services Department has until Sept. 1, 2010, to write the standards.
Bartz said the bill leaves cities with a clear choice.
"We now have a state law whose purpose is the elimination of rogue group homes through the licensing of facilities who purport to assist the disabled," she said. "What the city does with this opportunity is their call. They have two choices, the political one or the right one."
Originally posted on http://j3nny3lf.dreamwidth.org - but you can comment either here or there. I prefer HERE!