Consider This

"Unjustified isolation" is what a judge called New York's adult homes in a decision last week that found the state guilty of violating the Americans for Disability Act. The case asked whether adult homes re-segregated people with a mental illness who could live more successfully in supported housing. Yes, wrote U.S. District Court Judge Nicholas G. Garaufis, the evidence was "overwhelming." The case was brought six years ago by Disability Associates on behalf of 4,300 New York City residents who were assigned to homes licensed by the state's Department of Health and Office of Mental Health.

Last week's bold and lengthy ruling (210 pages) states clearly that New York didn't do enough to make sure people with a mental illness got the best shot at living fulfilled lives. Their residences in adult homes were originally seen as alternatives to locked wards, stepping stones to returning to the community. But they became impediments not opportunities. The picture that emerged from 300 exhibits and 29 witnesses included: lack of privacy; punitive rules; locked doors; policies inhibiting social contacts; and minimal opportunities to interact outside the home. Monthly trips to Wendy's and after-hour visits to museums in ambulettes promoted interaction with other residents, not the community.

To answer whether the residents were qualified to live in supported housing throughout the community, rather than in "urban ghettos," DAI relied on experts and the court accepted their professional assessment. It also noted that evaluations conducted by the defendant, New York City, came from an electronic application form and doctors did not perform clinical assessments. This contributed to the judge's decision that many of the people found in the adult homes could have been better served in supported housing.

Judge Garaufis left little doubt that the system continues to fail residents:

Given the very nature of the Adult Homes, the opportunities to develop social and employment contacts are extremely limited. As Defendants' experts conceded, living in a place where the phone is answered "Brooklyn Adult Care Center" diminishes work options and social contacts, and being subject to visiting hours diminishes opportunities to cultivate social or family relationships.

Integration in the community is more than that simply locating homes, some in excess of than 120 residents, near stores and parks, as the state argued. Nor is it adequate that these homes and their operators meet state regulations, sometimes deemed ineffective and substandard. The ruling clarified that New York cannot discriminate against people with a disability, something decided by Olmstead a decade ago.

How ironic that this case, six years in the courts, was announced soon after the 10th anniversary of Olmstead.

It is fitting that last week's decision was first carried by the New York Times. A year-long series, and awarding winning articles by Clifford Levy in 2002 brought the matter to attention.

Let's hope business as usual doesn't slow implementing the services that should have been delivered long ago.

Elsewhere:
New York Times Despair's Profiteers

Bazelon Center for Mental Health Law

Comments (2)
Marco:

New York State MUST Appeal

In regard to Judge Nicholas Garaufis’s decision (Sept. 8, 2009) in a case brought by Cliff Zucker of Disability Advocates against the State of New York, there are many disturbing aspects. This lawsuit was about whether or not NYS violated the federal Americans with Disabilities Act (ADA) by referring former psychiatric patients for housing in adult homes. The plaintiffs argue that these adult homes are in affect segregating their residents from a normal life within the community by virtue of the homes being too large, too regulated, and not providing the proper services. The defendant in this case is the State of New York and was defended by the NY Attorney General’s office. The judge wrote a 210 page decision outlining the reasons (all based on newspaper articles from 9 years ago, and misinformation presented by the plaintiff) why he ruled that the State is in violation of the ADA. The plaintiffs demanded, and the judge agreed, that these residents should be moved to Supported Housing units (which don’t exist) because it will not cost the State more than the cost of Adult Homes (???).
Let us for a moment look at the numbers. This ruling was focused on almost 30 facilities all in the NYC area housing approximately 4,300 ‘mental health’ residents according to the suit. The residents of these Adult Homes receive monthly SSI checks (level 3) to cover the rent and for their own spending money. The monthly rent amount that the facility gets is $1190 ($39 per day), which covers room and board, daily housekeeping services, recreational activities, case management services, medication management, three meals (and snacks), laundry, security, and coordination of all outside services such as medical appointments and transportation. It is important to note that these homes do not bill Medicaid and are not health or medical facilities and therefore do not have any other source of funding.
“Supported Housing” is basically an apartment with a kitchen and the necessary services are brought in from the outside at extra cost. These units cost approx. $100 per day per bed ($3,000 per month). Not even accounting for NYC’s current housing crunch, it would cost the State a conservative $200,000 per bed to construct these units. That means the State would be looking at approximately $860,000,000 just to create 4,300 new beds, and this number doesn’t even include the interest payments or operating costs! The existing adult home system at $39 per day from SSI (half of which comes from the feds) times the 4,300 residents in question is a State cost of only $31 million. So, any idiot (advocates and judges not included) can figure out that 31 million is cheaper than 1 billion plus.
The taxpayers and citizens of New York State should not only be demanding that the State appeal this ridiculous ruling, but we also deserve an answer to some other questions such as:
• What is the real agenda of the ‘advocates’ (Plaintiffs)? Do they have hidden interests in the creation of Supported Housing? Do they also represent housing groups looking for a windfall from the State?
• Are the Plaintiffs really representing all (or even a majority) of the residents of these homes? How many residents do the advocates speak for? Are the satisfied residents getting the same opportunity to be heard?
• Why weren’t the facilities named as defendants with the State? Were the plaintiffs concerned that they would put up a real defense and not lose? Why weren’t these facilities at least called to testify at the trial as to the mental and physical conditions of their residents?
• Why does it seem that the entire case was based on old information as to the condition of the homes, the condition of its residents, and old newspaper articles? Why are the real facts as to costs not represented? Why wasn’t a recent study showing that very few of these residents are actually able to live on their own given more credence?
• Why was this entire case only about the facilities in NYC? If the agenda was really to enforce a perceived violation of ADA laws, why not include all the facilities in the entire State?
• Was the Judge’s apparent conflict of interest (his wife is Elizabeth Seidman, a director/board member of a supported housing group) waived by the State? If so, WHY? Does that explain why this judge takes this case so ‘personally’?
Let’s not be fooled into thinking that the New York Times articles in 2001 describing bad conditions at a few facilities (which have since closed) are the norm in the Adult Home industry. The vast majority of facilities do an outstanding job (even with the limited resources) at caring for a population that would otherwise be homeless, in hospitals, or in jail. The fact is that residents of adult homes are not segregated, to the contrary, they live in the community, many go to work or outside day programs, and get the many services they need within the home. Not a single adult home resident was forced to live there or sign a contract. They chose to live in a place that they can call home and receive the many services they desperately need. Many comments have been posted online from ordinary citizens objecting to these residents living next door to them, with some even saying that they should be moved next door to the judge. Newspaper articles have been written claiming that the homes will be shut down because of this verdict. The sad fact is that many adult home residents are reading all this and wondering who these advocates are and who appointed them as representatives.
Stand up Governor Paterson and appeal this crazy verdict. New York State is facing a 10 billion dollar deficit and doesn’t need to be extorted into making a payoff to those with their own questionable agendas.

Posted by Marco | December 24, 2009 4:52 PM
MH Professional:

The previous post refers to Elizabeth Seidman, a long time Hillary Clinton supporter with strong ties to her native Virginia, who is the hidden impetus behind this "pillow talk" decision. Of her many political involvements, the most noteworthy is her board status of the largest supportive housing provider in the industry. The untold windfalls from this decision will be reaped for many years to come. The damage will take decades to recover from, reminiscent of the aftermath of Mario Cuomo's community dumping of the chronic mentally ill from state hospitals in the 1980s.

And now Andrew Cuomo will soon be in the driver's seat with the support of Seidman, Garaufis, et al. What a coincidence.
Wouldn't it be decent if we as a society finally planned appropriately for the disenfranchised mentally ill who are political footballs for opportunists and elitists like these two.

Posted by MH Professional | March 4, 2010 1:40 PM
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