Adult Care or Family Care Homes: the New Prison for Those w/ Mental Health Challenges

I'm on my way to see two of my clients in their Adult Care Homes (ACH) also known as Family Care Homes. Chris Fitzsimmons of NC Policy Watch has recently written about the trajectory of how people w/ mental health challenges usually end up in such a place and this is certainly my experience. They get into a pickle related to their mental health behaviors, there is nowhere to go, and so they get warehoused in the ACH's.

If you don't think they sometime function like prisons, remember I was threatened to be arrested by the Buncombe County Sheriff's Department for rendering therapy to a client of one of these homes in Western NC a year and a half ago. I took the matter to the Buncombe County DSS where they allowed the manager of the home to try and dress me down with the Adult Care Licensure people sitting mutely in the room (see their rules and regs here: don't bother with making a complaint for it will come back 'groundless': http://www.dhhs.state.nc.us/dhsr/acls/index.html)

While there are some exceptions, usually they are run like petty fiefdoms with the residents having little privacy. The residents have no spending money as their disability checks are consumed by the owner of the ACH, except for $66 (mark of the beast, ya know), minus their co-pays for their medical prescriptions and doctor's visits, every month. That would leave most of them about $45 for the month.

As per the state guidelines, the cost of staying in such a home is about $1300/ month and this includes a room (usually shared), a 24/7 Supervisor-in-Charge or SIC (they have a terrible burn-out rate given that they usually live there themselves), food on the table (gets pretty grim sometimes and is completely dependent on the ability of the SIC to cook), and plenty of boredom.

99% of these people are not working either because they are too disabled (and the longer they don't work the more likely it is that they willn ot work) or have no way to get to a supported employment facility such as Haywood Vocational Opportunities in Waynesville, NC (a good place for people to work, for the most part), or they would lose their disability checks if they go over a 'bright line' of earned income which is approximately $12,000/ year.

So, if they're working, they could earn 1 million $$ or $12,001-----the results would be the same: they would lose their disability checks until the entire sum of what they earned was paid back. Talk about a complicated system that will chew you up......

If NC wants to do something about warehousing these people, which is what is taking place---and yes,these are the new state mental health hospitals.....only privatized......what has to be addressed is a significant way to improve the quality of life of these people and that would include they being able to work and feel like functioning people within the community.

Oh, that would mean there would have to be more jobs of course......and more sheltered workshops.

Below is what Fitzsimmons has to say. Additionally, here are some of the links to my previous notes on the problems w/ the Adult Care Homes also known as Family Care Homes, in NC:

*************************************************************************************
Wednesday, April 08, 2009

WNC (Family Care) Homes: DSS Buncombe finds rule violation as re: mental health client re: opening of private mail
see: http://madame-defarge.blogspot.com/2009/04/wnc-family-care-homes-dss-buncombe.html

***********************
Wednesday, May 13, 2009

NC Family Care Homes: mental health issues go unaddressed & providers are banned from premises: defacto mini-prisons
see: http://madame-defarge.blogspot.com/2009/05/nc-family-care-homes-mental-health.html

***********************
(what the Adult Care Home people do during the day time----or not-----as re: the local library system; they take a lot of medication that has, as a side effect, fatigue):

Buncombe County Library system: No place for the sleepy
by Marsha V. Hammond in Vol. 16 / Iss. 17 on 11/18/2009
see: http://www.mountainx.com/opinion/2009/111809buncombe_county_library_system_no_place_for_the_sleepy
**********************************************

What Fitzsimmons recently wrote about these homes:

http://www.ncpolicywatch.com/cms/2010/09/15/north-carolina%E2%80%99s-broken-emergency-mental-health-system/

"......
Because there were no beds available at any of the State's psychiatric hospitals he stayed handcuffed to a stretcher in the emergency department with a 24-hr. police detail. Finally, after 96 hours without treatment, he calmed down and was discharged but his elderly parents were afraid to let him come home. His options - live on the streets - homeless - or find a bed in an adult care home (ACH). Either choice left him without treatment for his mental illness increasing the chance that it would happen again.

Sadly, this is not an isolated story. Over 6,000 adults with mental illness live in ACHs in North Carolina. And that number only reflects people with a known mental illness. There isn't an accurate count of the number of people who would rather be homeless than live in an institutional setting like an ACH or who are not receiving any services at all. With extreme cuts in funding, that number is likely to grow and include more people with other types of disabilities......"