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At the end of May, New York State suspended the license of the current operator of Leben Home, the adult home profiled by The New York Times this past spring. The Times not only reported on the abominable quality of Leben Home's ongoing operations, it also described a brutal medical scam through which some of the home's residents were subjected to unnecessary major surgery. How could the sub-human conditions go on for years? Where was the government oversight and regulation needed to protect the home's residents and assure a minimal quality of life?

My contact with adult homes began more than twenty years ago when I represented the Coalition of Voluntary Mental Health Agencies on a committee convened by the Community Council of Greater New York to advocate for improvements in adult home operations. At that time, an increasing number of adult home beds were being filled with persons with mental illness being discharged from the State hospital system. Then as now, the vast majority of homes were operated as for-profit businesses. The New York State Department of Social Services was responsible for oversight of the homes. What struck me was that the regulations were very detailed regarding some aspects of home operations but totally silent on vitally important issues such as meeting the special needs of mentally ill residents.

In a way this was not a surprise. Adult homes were licensed by the State Department of Social Services, not as facilities for the mentally ill, but as homes for the elderly who needed a measure of personal care. Many adult homes became de facto mental health facilities by virtue of the large number of discharged State hospital patients who filled many of their beds. The homes achieved this dubious status because of the State's failure to plan for adequate residential or community-based services during the years of deinstitutionalization. In the absence of a planned housing program, adult homes, together with SROs, became housing resources of last resort.

It is clear that between the profit motive of the owners and operators and the lack of designed programs and amenities for their mentally ill residents, this would be a recipe for disaster. The recent scandals at Leben Home attest to government's total failure in demanding appropriate, quality services for persons with mental illness in adult homes.

What can be done? A place to begin is educating the public about conditions in adult homes. The more the public understands what is happening in the homes, the more pressure will build for meaningful reform. Such pressure must be brought to bear on State government officials and our State legislative representatives in the Assembly and Senate. If you or anyone you know has a story to tell about sub-standard conditions in adult homes that serve persons with mental illness, I urge you to share your story with elected and public officials, as well as with the State Commission on Quality of Care for the Mentally Disabled.

OMH also regulates care in adult homes. Why didn't they see irregularities?

The future for persons with mental illness in adult homes could be bright if the public demands reform and government responds positively. Adult home beds could potentially be a highly valued community residential resource. Public education and concerted government action could make a difference. It is up to us to continue the advocacy until the State moves decisively to assume responsibility to improve the quality of life of adult home residents.


Express yourself on the adult home issue -- write to:
Honorable George Pataki
Governor of New York State
Executive Chamber, State Capitol
Albany, NY 12224 Honorable Sheldon Silver
Speaker of the Assembly
Legislative Office Building
Albany, NY 1224

Honorable Joseph L. Bruno
Majority Leader NYS Senate
Legislative Office Building
Albany, NY 12247
Honorable Deborah J. Glick
Chair, Social Service Committee
Legislative Office Building
Albany, NY 12248

Honorable Raymond Meier
Chair, Senate Social Services Committee
Legislative Office Building
Albany, NY 12247
Honorable Martin Luster
Chair, Assembly Mental Health Committee
Legislative Office Building
Albany, NY 12248

Honorable Thomas W. Libous
Chair, Senate Mental Health &
Developmental Disabilities Committee
Legislative Office Building
Albany, NY 12247

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