New Yorkers, Adult Homes

“Adult homes warehoused mentally ill people for decades”

Part II of this exposee’

Change, Challenged:

In 2013, state legislators passed a law requiring large adult homes to reduce the number of mentally ill people living in their homes beneath 25%. Under the settlement, the Department of Health would have to collect compliance plans from the homes showing how they intended to achieve that goal.

In 2014, the state offered the adult homes a way to meet the mandate while keeping their beds full. “Our understanding was that the conversion was intended to allow Transitional Adult homes to attract new geriatric residents to replace the Seriously Mentally Ill residents who were vacating,” Lisa Newcomb, another adult home industry leader, said. Since then, at least 12 homes have obtained assisted living licenses. However, six years after the settlement, most of these homes still have a census of mentally ill people above 25%. At some, they make up the majority of residents. Adult home representatives say the census is largely out of their control. They say the residents who remain either don’t want to leave or have been told they should not by clinicians who have found that they are too medically or mentally fragile to live on their own in supported housing. However, Clarence Sundram, the independent monitor assigned by the court to oversee the transition, has found that the staff of many of the homes has discouraged people from moving out. The incidents are documented in his yearly reports. Sundram learned that the staff at one home had called residents’ relatives to express concern about the residents’ interest in supported housing. At another home, a staffer scared a resident by suggesting the person would likely wind up homeless. At New Haven Manor in Far Rockaway, Queens, administrators drafted a form letter signed by 74 residents saying they did not want to move, Sundram wrote. Some residents told Sundram they did in fact want to go, but they simply wanted time to ease into the transition. Administrators did not respond to a reporter’s phone calls or emails to discuss these allegations. Newcomb, whose trade group began representing New Haven this year, said the home has new leadership, but to her knowledge, the previous administrator drafted no such letter.

At Mermaid Manor in Coney Island, Brooklyn, the Department of Health substantiated four separate allegations of administrators discouraging residents from moving into supported housing. One staff member, reached by phone, said these allegations were not true, but he refused to give his name and said administrators might call if “they feel like it” to discuss further. Nobody did.

Overall, the state remains behind in its deadlines to move residents out. In the first year of the settlement, only 40 residents moved; the next year, 245; the third, 491. Within four years of the settlement, the state had intended to assess some 2,500 residents and move out those appropriate. As of this month, five years later, they have only moved around 800.

The Queens Adult Care Center has now designated at least 100 of its 352 beds for the frail and elderly through an Assisted Living Program. Despite complaints of obstruction, Mermaid Manor was approved for assisted living, while New Haven Manor is awaiting final approval. Bruno, the Department of Health spokesman, said that “it would be inappropriate for us to require compliance with the settlement before facilities can be awarded ALP beds” because the beds were also offered to homes that were not part of the litigation. He said all homes must be in “substantial compliance” with regulations before being granted a license, including Mermaid Manor, which submitted “a plan of correction” and has had no further issues. Jeffrey Sherrin, an Albany-based attorney who represents many adult homes, including Mermaid Manor, said in an email that the “claims of interference” there are years old, and “stale.” He said that the “failures of the State to meet its targets … have nothing to do with non-compliance, but rather everything to do with misunderstanding life in these homes, and the needs and preferences of the residents in them.”

“There are no secret deals or devious attempts to evade regulations,” he said. “The system is working how it was supposed to — residents are receiving the care they need, and the State is saving money and avoiding nursing home admissions.” Sherrin has challenged the settlement in lawsuits filed in state courts all over New York. In one, he argued that a regulation central to the settlement prevented a single, anonymous resident from moving back into an adult home after struggling in supported housing. Instead of simply allowing that man to move back, the state agreed to suspend its own regulation, effectively reopening the door for adult homes to take in people with mental illness.

U.S. District Judge Nicholas Garaufis, who is presiding over the settlement, was livid. At a hearing in March 2017, he called in top state officials and upbraided them. “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,” he said. The only person it may have angered more was Introne.

“My whole plan went to hell,” he said. If Introne’s idea was carrot and stick, the state had given away the carrot without ever wielding the stick.