Monday, April 17, 2017

Federal Judge Angered by New York Falling Short in Resettling Mentally Ill Adults

Four years ago, after more than a decade of litigation and negotiation, New York State officials agreed that the system of often dismal and dangerous adult homes was no place for the mentally ill.

article by MARC SANTORA for The New York Times | APRIL 14, 2017
They agreed to move as many as 4,000 mentally ill residents out of their apartments and into supportive housing, a hard-fought recognition that people with disabilities should have the opportunity to live independently and participate in all aspects of community life.

But as a July deadline nears, a federal judge has found that the state seems far from meeting its commitment: Fewer than 500 people have actually been moved into supportive housing from adult homes.

But what the judge, Nicholas G. Garaufis of the Eastern District of New York, found most troubling was that the state appeared to be working with the adult home industry to undermine the settlement.

“I will not allow the kind of political, legal activity that is going on in this case behind my back and behind the backs of the plaintiffs to continue,” Judge Garaufis said at a recent hearing. “If I sound dramatic, it is because it is dramatic. It’s about them. It’s about 4,000 people.”

The Department of Health had quietly reached an agreement with home operators in state court that would have short-circuited the execution of the federal settlement — without ever informing the federal court.

“There’s some sort of a deal,” the judge said. “That’s how it appears. And we’re going to find out exactly what the deal is, because if there is a deal, I would consider it a fraud on the court.”

Adding to the chaos, the state attorney general’s office — the legal representative of the state — said it was unaware of the negotiations between the state and lawyers for the adult home industry “until it was well underway,” and asked last month to withdraw from the federal case, citing irreconcilable differences with its client, the state.

The highly unusual request was denied by Judge Garaufis, whose involvement in the case traces back to its beginnings.

The sprawling network of privately run and state-regulated adult homes in New York City — once considered a promising alternative to the bleak psychiatric wards that the state began closing in the 1960s — began to face increased scrutiny for a host of abuses. A 2002 investigation by The New York Times showed that many had “devolved into places of misery and neglect, just like the psychiatric institutions before them.”

Lawsuits were filed, and after years of court battles, the state reached a settlement that called for residents with mental illness to be moved out of the homes and into supportive housing and be given rental assistance and access to community-based services that promote their inclusion, independence and full participation in community life. The state was given five years to resettle 2,000 to 4,000 residents.

Diana Vila, one of the plaintiffs in the case, is one of the thousands of people who still have not been resettled to supportive housing.

She entered the system more than a decade ago, when a fire forced her from her apartment in Sunnyside, Queens.

She was already in a downward spiral, her depression worsening and her bipolar condition not properly medicated. Her mother, she said, was a victim of domestic abuse and had to escape to a shelter herself. Ms. Vila had recently lost her job and was growing distant from the rest of her family and friends.

With her apartment destroyed, she found herself in the hospital with no place to go.

So, as with thousands of other New Yorkers in desperate straits, she entered an adult home.

Ms. Vila, 54, was first sent to a home in Queens called Milestone. She described the conditions there as being “like a nightmare.”

There were frequent fights, a staff ill equipped to deal with people with mental illness, and general disarray.

To escape the home, Ms. Vila would get herself hospitalized as often as she could. After a year, she was transferred to Belle Harbor Manor in the Rockaways.

A couple of blocks from the beach, the facility was much cleaner and safer than Milestone, but it was still not home.

She misses her recliner chair, where she would sit with her cats and watch her favorite television programs. She misses cooking skirt steak and ordering takeout Chinese food. She misses hot chocolate heated up in her microwave and an occasional spoonful of ice cream at night. She misses buying cut flowers.

Like many others in the homes, Ms. Vila survives on disability benefits — $1,700 a month, in her case. She pays $1,500 to the adult home, which serves three meals a day. Breakfast is at 8 a.m., lunch is at noon and dinner is at 4:30 p.m.

She is left with $200 a month for everything else. After paying for her phone and cable, she has about $45 a month, which she uses to buy extra food.

Gaining control over her money — and by extension her life — was a big part of the reason she joined the lawsuit against the state.

“There’s so many things that I miss,” she said. “And it’s something that I want again.”

Last month, with the July deadline approaching, Judge Garaufis called all the parties into court for a hearing where, in blunt and caustic language, he warned that the state was “far from hitting its numbers.”

The state rejected the suggestion that it had done anything wrong.

“New York remains unequivocally committed to supporting adult home residents, which is why we are working tirelessly to meet the requirements of the settlement agreement,” the Department of Health wrote in a statement in response to a question.

Even before the hearing, however, advocates for the mentally ill said that the process for resettling residents was deeply flawed.

“The state’s system to help people move out of adult homes is not working,” said Cliff Zucker, the general counsel for Disability Rights New York. “Transition to community living has moved at a snail’s pace, leaving residents confused and frustrated. This is largely because the state has insisted on an inordinately complex process.”

The state officials, however, said that the complex process was necessary in part to ensure that people who moved out of the homes were ready to live more independent lives without endangering themselves or others.

Ms. Vila says she feels safe in her home, but safe is not a life.

“I am not growing,” she said. “I feel like I am standing still.”

Susan Beachy contributed reporting.
https://www.nytimes.com/2017/04/14/nyregion/adult-homes-mentally-ill-new-york.html?_r=0

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