Independent living homes for mental health go unregulated

Daniel Costa may have regained his freedom when he was released from prison 10 years ago, but his new housing arrangements have made it harder for him to escape life behind bars.

For years after his release, Costa was housed by the county’s parole program in unregulated, unsupervised group homes scattered across San Jose, where the food was bad, parolees were crammed into closet-sized rooms, there were no on-site guards and residents were constantly afraid “something would take away from them,” Costa said.

“These facilities are never going to change my mindset about being institutionalized,” Costa said.

Santa Clara County officials have warned that at least 100 privately owned and operated Independent Living Housing They are tucked away in residential neighborhoods across San Jose and County. There are many more prisons in the Bay Area and other parts of California, but no one knows exactly how many. They typically house formally incarcerated people and those released from psychiatric or addiction facilities.

Counties routinely rely on these facilities to house their most vulnerable people, but because operators aren’t required to be licensed, most have little oversight, even though they often receive public funds to cover tenants’ rent. Disability-rights groups and local officials say that leaves many residents languishing in poor conditions and sometimes without the care they need.

“You have people living in extreme poverty,” said Rhonda Brown, a behavioral health specialist hired by the county in 2022 to lead a review of independent living facilities and contribute to potential oversight strategies. Public meeting.

“If you want quality housing, you’re not going to get it if no one is going to check on you,” she told county officials at a March meeting.

At least 20 properties the county considers independent living housing are under investigation for possible code violations, according to public records, which cite mold and cockroach infestations, overcrowded bedrooms, unsafe construction without permits, drug use, exposed wiring and, in one case, bodily fluids that had not been cleaned up a month after a resident died.

Visits to two San Jose homes and interviews with five current and former residents revealed similar complaints, including mold, pests and unauthorized construction. City officials in San Jose, where most of the county’s housing is located, said some neighbors chafe at frequent drug use and police activity.

One reason for the lack of regulations is to limit red tape, and independent living homes can accommodate people more cheaply and quickly than publicly funded supportive housing, though more broadly. Behavioral health experts say that in areas like San Jose that have a severe shortage of affordable housing, independent living homes are an important option and can help keep people from falling into homelessness.

But unlike residential care facilities, which must be licensed by the state, independent living homes, which can be run by private operators with limited medical experience, are not required to provide supportive services, including mental health care, or even reminders for residents to take their medication.

That responsibility typically falls to the residents’ caseworkers, who advocates say are overwhelmed and sometimes find it difficult to make regular visits to the homes. Caseworkers, who are often employed by counties or nonprofits that contract with them, refer residents to facilities through loose connections.

State Department of Social Services officials did not directly respond to a question about how many unlicensed independent living homes there are statewide. Asked why the state chooses not to license independent living homes, the department said it licenses facilities such as residential care facilities for the elderly “in accordance with state law.”

At the urging of advocates, Santa Clara County earlier this year Apart from $2 million It would help independent living facility operators make repairs to their properties. In exchange, the agency and operators would agree to meet certain housing standards and could allow regular inspections. County officials said they have no timeline for finalizing the new program.

But starting next year, the county will begin inspecting all independent living facilities whose residents receive county rent assistance. County officials are still determining how many homes will be included in the inspections. They declined to say how much rent assistance the county will send to such homes. But they noted that the county also has direct contracts to place residents in at least 10 unlicensed independent living facilities.

Susan Ellenberg, chairwoman of the Santa Clara County Board of Supervisors, said the county should prioritize efforts to “bring more landlords into oversight” through funding for renovations and increasing the number of direct contracts with operators.

But even with all these efforts, it’s unclear how many facilities may fall through the cracks. Advocates are pushing a plan to make all independent living facilities accountable to county officials.

“You can’t just look at the housing that’s under contract or the housing that’s rent subsidized,” said Lorraine Zeller, a member of a working group advising the county on how to best spend the $2 million. “You have to look at everybody.”

One of its operators, Nelson Muang, said he opened the freestanding home in a leafy neighborhood north of downtown San Jose a few years after emigrating from the Philippines in 2006. His school-age children had recently followed him to the U.S., and Muang, who worked in a licensed residential care facility, decided to rent the home to families and also subrent rooms to residents leaving mental-health facilities.

“I couldn’t afford to buy a house and I had to raise my kids, so I had to make the best of the situation,” he said.

Muan said he typically charges about $700 a month for room and board, and that a nonprofit contracted by the county finds tenants for him. He said rent comes mainly from tenants’ Social Security and disability checks, and he makes very little profit. His children are grown and have left home.

Muan eventually opened more homes in rental properties around San Jose. At one point, he said, as many as 25 people were living in six homes. But residents were acting “unruly,” he said, destroying one home by setting it on fire and others stopping to pay rent during the COVID-19 eviction ban. Muan said he was forced to close all his homes except his original one because of the constant trouble.

According to court records, Muan has been evicted from four properties he believed to have been using as separate residences since 2017. It is unclear what happened to the residents.

Muan’s former property is currently the subject of an eviction lawsuit and a recently launched code enforcement action, and one resident and advocate who visited the property said the basement was infested with mold, pests and unsanitary conditions.

Muang blamed his landlord for the poor conditions, saying he had begun withholding rent after he refused to pay for repairs. Attempts to contact him were unsuccessful.

Muang’s sister also runs a struggling independent living home and is currently the defendant in a wrongful death lawsuit after a resident overdosed on a cocktail of fentanyl, methamphetamine and other drugs at one of her facilities. Attempts to contact Muang’s sister were unsuccessful.

“We can’t control what people do,” Muang said, “and if they die in their homes, it’s not our fault.”

Momentum for Health, a Silicon Valley mental health provider funded in part by the county, is also a defendant in the suit, which alleges the nonprofit placed residents in unsafe facilities without “proper medical oversight and licensure.”