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Shelter for Mentally Ill Operates With Few Rules, Little Oversight

Housing: Inspectors find 'deplorable conditions' at Echo Park facility known as Dad's House. Owner says he provides a last-chance refuge.

September 09, 2002|CHARLES ORNSTEIN | TIMES STAFF WRITER

They may be cluttered and less than pristine, but Darryl Cannady considers his two boardinghouses in Echo Park a last-chance refuge for mentally ill patients who would otherwise be on the streets.

Los Angeles County mental health officials have described the conditions in court documents as "horrible and illegal," citing filthy mattresses and bathrooms, overcrowding and medications stored "randomly" in the open. They liken Cannady's two houses to one in the San Gabriel Valley that aroused concern because five of its residents died this year.

But no one has died at Cannady's houses--both known as Dad's House--and they remain open, providing sorely needed shelter to vulnerable occupants.

The problem, county and state officials say, is that such facilities exist in a regulatory netherworld, subject to few rules and little oversight. That can lead to abuses that are difficult to detect unless there is a complaint, and by then, it may be too late.

Facilities that provide care and supervision to residents are required to be licensed by the state, but many unlicensed boardinghouses provide these services illegally--including disbursing Social Security checks and coordinating medical care. No one knows the precise number or locations of such unlicensed facilities in Los Angeles County.

The California Department of Social Services cited Dad's in May for providing illegal care and later fined the operator $4,000. But the houses remain in operation while Cannady's attorney contests the fine.

Cannady argues that he operates the equivalent of an apartment building, which does not require licensure.

"It's a tricky deal," said John Gordon, a spokesman for the state Department of Social Services. "When we find someone that's unlicensed, we don't have a lot of jurisdiction.... We don't have the authority to shut them down."

In essence, Gordon said, authorities depend on operators to be honest about the type of services they provide and to seek a license if one is required. His agency also depends on mental health officials to monitor where psychiatric hospitals refer their patients upon discharge.

"We're really focused on the facilities that we do license and making sure that they fall within the regulations," he said. "However, when we have these [unlicensed] situations, we try to get them resolved."

Deaths at One Facility

Regulators have struggled with how to handle unlicensed board-and-care facilities for years, but the debate gained urgency after five residents of one San Gabriel house died this year.

The most severe penalty to arise from the deaths, however, targeted not the San Gabriel house, but two of the psychiatric hospitals that referred patients there. The county Department of Mental Health stripped the hospitals of the authority to detain mentally ill patients against their will.

In court papers, the county also cited the hospitals' referrals to Dad's as justification for its action.

Hollywood Community Hospital of Van Nuys, where Cannady works as a chef, and City of Angels Medical Center-Ingleside have sued to have the sanctions overturned. Los Angeles Superior Court Judge David Yaffe upheld the sanctions Friday.

Meanwhile, county and state authorities try to keep an eye on Dad's.

During an April visit to one of the houses, on Clinton Street, inspectors found an open container of malt liquor on the kitchen table. Dad's has billed itself as a sober-living house, but Cannady now says it is for "independent living."

On a return trip in June, inspectors described "deplorable conditions": clothing and medications strewn all over the floors; furniture broken and torn; tarps covering the windows, and numerous holes in the wall, according to a court affidavit filed by Barbara Leifer, a patients rights advocate with the county Department of Mental Health.

"There needs to be a better system," Leifer said in an interview. "There needs to be a system where people do get in trouble--there are punishments, there are repercussions."

Regulators can--and have--removed seriously ill patients from unlicensed facilities and placed them in houses licensed to give them the care and supervision that they need.

But sometimes patients return to the unlicensed boardinghouses, and regulators are nearly powerless to stop them.

It's all the harder to intervene because conditions can change dramatically from day to day, as can the health of residents, officials said.

On Aug. 30, for instance, Cannady invited a reporter to visit his two houses. The furniture and carpets were soiled, and a broken-down car and appliances sat in the front yard.

But no medications were strewn on the floor, and no liquor was on the table. Mental health officials, who showed up during the reporter's visit, confirmed that conditions appeared better than inspectors described in April and June.

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