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If there are any other comments you want to make or direct to the committee for purposes of this hearing we would appreciate hearing from you. You can send your comments to the committee, as the instructions say, on your way out.

To you who sat here and listened, to learn and to help, we thank you, and for those who worked hard to testify, we thank you very much.

I must be in Santa Fe by 2 p.m., that means I have got to get there by car, and to some of the press, I have promised 10 minutes for an interview, so I am going to be late in Santa Fe, but it was a pleasure being here with you all this morning.

Thank you very much. [Applause.]
The hearing stands in recess.
[Whereupon, the committee was recessed at 1 p.m.]

APPENDIXES

Appendix 1

REPRINT FROM THE ALBUQUERQUE TRIBUNE OF A SPECIAL REPORT ON BOARDING HOMES IN ALBUQUERQUE, N. MEX.; BY LAURIE McCORD, TRIBUNE STAFF WRITER

[Albuquerque Tribune, May 13, 1974)

ABUSE, NEGLECT Too OFTEN MARK GOLDEN YEARS

(First in Series) "I walked in and found a woman tied to the toilet with a sheet.

"I asked the aide what on earth was going on. She said they were trying to ‘regulate the woman, that the woman was always messing np her bed.

“I asked if they had taken her to a doctor, and the aide said they had not. "I untied the woman. She was black and blue. She was paying the full $175."

The story is told by Anne Beckman, director of the Albuquerque chapter of the American Association of Retired Persons.

It is the account of a visit she paid to an Albuquerque boarding home for the elderly.

Another story about a boarding home for the elderly in Bernalillo County appeared in the newspapers here recently. It told of the alleged beating of an 82year-old woman by the proprietor of Mi Casa Su Casa boarding home at 2332 Margo SW.

In that incident, the Bernalillo County Sheriff's Department took action, arresting the proprietor, Mrs. Laura Andrade.

There is chilling evidence, however, that other incidents just as grisly-incidents such as the one witnessed by Anne Beckman-may not be at all uncommon. And even when such incidents are reported to authorities, the evidence further suggests, they often go unchecked.

A month-long investigation, including visits to more than 15 boarding homes in Bernalillo County and conversations with some 40 persons connected in one way or another with boarding homes, has produced the following reports:

- In some boarding homes, “incontinent" old people are left to lie for days on wet sheets or in their own excrement.

-In some facilities, people have been found shut up in basements or locked in their rooms.

-Workers in one boarding home recently found an old woman with a halfinch crust on her head from lack of bathing, another with her nylons rotting onto her legs, and another with toenails like claws, so long she could not put on shoes.

-In one South Valley boarding home, residents must go outside, even in midwinter, to get to a central bathroom. In that home, and in others, the stench of urine in the sleeping quarters is almost overpowering.

-Social workers around the state report that many welfare recipients living in boarding homes are lucky if they keep any of their welfare payments for personal expenses, that some operators have the checks signed directly over to them.

-Lunch in many boarding homes has been found to be no more substantial than dry toast or a chunk of carrot boiled in water; in some, only two meals a day are served.

Situations such as these do not occur in all boarding homes.

Everyone interviewed mention examples of fine, caring homes such as Padilla's, at 2111 Raven Lane SW. And some insisted that the gruesome situations occur in only a small minority of homes.

41-055-754-5

But incidents of abuse and neglect, of ignorance and exploitation, do go on.

And there is a complex network of unfortunate circumstance, indifference and bureaucratic bungling that seems almost to foster such incidents in boarding homes.

In Bernalillo County, there are roughly 35 boarding homes licensed by the state Health and Social Services Department for a total capacity of about 350 residents, Robert Frankalucci, head of the HSSD institutional licensing section reports.

Not temporary abodes for transient workmen passing through town, nor the old-fashioned boarding houses where townsfolk gather for dinner on Sundays, these boarding homes serve a different function.

They are homes for the dispossessed, people who cannot survive alone, but whose families where there are families—cannot or will not keep them at home.

Some of the boarders are mentally handicapped adults. But by far the largest number in Bernalillo County homes are merely aged.

Some are senile, some just physically wearing down.
They are not sick ; they do not need hospitals, or even nursing homes.

But they do need care. Someone to cook their meals, or to help them remember when it is time to eat.

Someone to help them comb their hair or take a bath, or to make sure they get to a doctor should they become ill.

There is a name for this kind of care. Custodial care, it is called.

And New Mexico, theoretically, has taken into account the need for custodial care with a special state license for "sheltered-care homes."

A sheltered-care home, the licensing regulations state, is a "place which provides, on a continuing 24-hour basis, facilities and resources to give personal services (but no skilled nursing care) to two or more persons not related to the operator."

Those persons, the regulations continue, are ones who "because of age, infirmity, physical or mental limitations and dependence, need help and assistance in daily living activities.”

The “personal services” to be rendered, the regulations suggest, might include such things as help in walking, getting in and out of bed, bathing, dressing.

Neatly, on paper, the need has been met.

But in reality, there are only about seven licensed sheltered-care facilities in the entire county. and all are full, Joan Tefft. county supervisor of adult services with the HSSD Social Services Agency, said.

And so hundreds of needy, but technically not ill old people must look elsewhere.

If they happen to be wealthy, or if their families have enough money, they probably can be placed in a nursing home, even though they do not need medical care,

If they must rely on Medicaid, however, they will not be admitted to a nursing home, for in a nursing home situation, Medicaid covers only actual illness, and not the ordinary pains and needs of growing old.

The only alternative for a large number of the elderly poor is a boarding home.

And under state licensing requirements, a boarding home is required to provide little more than a bed to sleep in and food to eat.

Many of Bernalillo County's boarding homes—the large majority, probablydo provide a somewhat higher level of service than the minimum required by law.

But often, the quality of that service is directly proportionate to the cost.

Sandia Ranch at 603 Edith NE, a sprawling, homey structure that once served as a mental hospital, is often praised for the quality of its care.

The home has an extensive staff of aides and orderlies to tend to the residents' needs, and there is even a full-time nurse on duty.

"We cater to their every wish" said proprietor John Chanman.
But rates at Sandia Ranch, start upward at around $350 per month.

And for large segments of the elderly population, $350 a month is a sum quite impossible to obtain,

There are an estimated 248 aged and mentally handicapped persons in Bernalillo County boarding homes who live on public assistance, welfare.

The federal government, which as of Jan. 1, took over formerly state-admin. istered financial assistance programs for the elderly, blind and disabled, pays a maximum of $140 per month.

Countless other persons in boarding homes subsist on Social Security payments, which now average $174 a month. Others survive on small pensions providing roughly the same income.

For all those people, there is not much choice as to where they end up.

They land in boarding homes willing to take low-income residents. If they're lucky, they get good food and good care. If they're not. . .,

Anne Beckman, whose organization helps find employment for retired persons, tells of one boarding-home owner who called her a year ago at Easter time.

"She wanted a cook-housekeeper. I sent a woman to the home at 3 p.m. on Friday. She found nothing at all to eat for dinner, and she had to call her husband to go out and buy groceries.

*The next day, the owner arrived with food for dinner that night: one slice of ham and one potato. She told the woman to slice up the potato and give everyone a couple of slices.”

Visiting nurses who go into boarding homes to tend patients after their release from hospitals have many stories to tell of their encounters in boarding homes.

Jan Thornberg and Judy Mitchell of the cocperative St. Joseph and Presbyterian Hospitals Home Health Care program tell of nurses being turned away at the door by boarding home proprietors.

Ms. Mitchell, director of the program, said she has seen only one decent boarding home in eight years of nursing.

Muriel James, director of the Visiting Nurses Service, Inc., described a visit by one of her nurses to a home where the water and toilets had been turned off, apparently to reduce the water bill; where the food consisted of watery sopp; and where residents bore definite signs of mistreatment-explained by the owner as the result of falling out of beds.

Mrs. James said she reports all such situations to various state and local authorities, but said in frustration that she has been reporting them for years.

Most of those authorities indicate that they are aware of conditions in boarding homes.

“Some of them admittedly aren't so good," said Bill Allen, Chief Sanitarian with the General Sanitation Division of the city-county Environmental Health Department.

Other people-a former adult specialist with HSSD program development now a social work professor at Highlands University, for one_put it a little more strongly.

"The situation is deplorable, and that's an understatement," said Highlands' Adelina Hill.

"The definition of a boarding home in New Mexico is a flop house.

"Many of the homes are overcrowded. Some are licensed for eight people and have 12.

I've seen the operators give them half a Vienna sausage out of a can for lunch. I've seen filthy, filthy dishes stacked up. One place doesn't let residents burn lights after 5:30.

“There's no one to monitor the monthly fee,” Ms. Hill continued. "Some operators rip off the whole check.

"It's incredible that the situation has been kept under wraps for so long."

Albert Sanchez, staff social worker at Bernalillo County Medical Center, in charge of finding suitable situations for persons who might need supervision after their release from the hospital, said he tries to avoid "resorting to" boarding homes.

And one reason, he said, is the condition in which some patients come to the hospital from boarding homes.

Once or twice a month, Mr. Sanchez said, people who have fallen in a boarding home and dislocated a hip, or broken a bone, are brought to BCMC—one or two days after the accident has occurred.

The list of boarding home critics is long.

Barbara Menzie, director of the Metro Areawide Aging Agency also uses the term “flophouse" to describe most boarding homes today.

“In one home, they found three old ladies in a basement, one in a wheelchair. There were no windows, and they hadn't seen the light of day in two years. One of the ladies' son was a banker. He couldn't have cared less."

Lt. Paul Adent of the Albuquerque Fire Prevention Bureau, which does at least yearly inspections of Albuquerque's boarding homes, voiced perhaps the most resounding condemnation of the homes.

"Even the penitentiary,” he said, "would be better than some of these places."

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[Albuquerque Tribune, May 14, 1974)

GREED, POVERTY? BOTH ARE ALLEGED

(Second in Series) The roots of the boarding-home problem in Bernalillo County are hard to define, lost in a mire of blame and defensiveness, accusations and excuses.

There are critics who charge greed, and defenders who plead poverty; there are charges of malice, and defenses of ignorance. There are claims that regulations are too strict, and that they are too lax.

Most likely, the problem is rooted in all those areas. For boarding homes are a complex problem, not easily laid open and not easily solved.

Money is a major area of contention.

Many people, from boarding-home operators to their harshest critics, feel the sums of money boarding homes receive from welfare recipients—who may constitute more than half of the roughly 350 residents of Bernalillo County boarding homes-are simply not high enough.

The federal government, which on Jan. 1 took over all formerly state-adminis. tered programs of financial assistance for the elderly, blind and disabled, currently pays those welfare recipients a maximum of $140 per month.

Assuming the boarding-home operator feels his boarders should have $20 a month for personal expenses, the maximum fee he can charge welfare recipients is $120, or about $4 a day.

J. Patrick Kneafsey, director of the city Environmental Health Department, said he can't imagine running anything other than a "flop house" for $4 a day.

"You can't even buy food for $4 a day," he said.

"Even in your own home,” agreed Anne Beckman, Albuquerque job placement director for the elderly of the American Association of Retired Persons, "you couldn't take care of someone for $120 a month."

That $120 a month is a considerable jump from the amount boarding-home operators could charge welfare recipients before the Jan. 1 federal takeover.

When the state administered aid to the elderly and disabled, there was an $88-per-month limit on what an operator could charge, with an additional $22 reserved for the recipient's personal use.

And just two years ago, the state-mandated maximum charge was $66.
But operators say the recent increase is being outstripped by rising costs.

Connie Padilla, who runs a highly regarded boarding home at 2111 Raven Lane SW, şaid her grocery bills are climbing by $20 to $30 each month.

"Seven of Mrs. Padilla's nine boarders are welfare recipients.

Mela Anaya, who operates another well-reputed boarding home in the South Valley house where she was raised, takes only private-pay patients for a fee of $150 a month.

Yet even at that rate, Mrs. Anaya says she fears she may be driven out of business by rising prices.

"Some of these people can eat $90 worth of groceries a month, what with the fruits, milk, vegetables, juices, eggs,” she said.

"And if I can't make a profit with private patients, I can't imagine what it's like with welfare patients."

Mrs. Anaya points out that operating a boarding home well is not an ordinary job.

“This is 24 hours a day, seven days a week,” she says. "These people need care, they need help.

“A person could never get rich doing this.”

Some observers, however, contend that quite the opposite of struggling to get by, many boarding-home operators are enjoying enormous prosperity.

They concede that operators such as Mrs. Anaya and Mrs. Padilla, who give good, concerned treatment for a relatively low fee, may not be getting rich.

But they note the homes which charge upwards of $400 a month.

And even many homes with low-income boarders, they claim, are making sizable profits by skimping on meals, not worrying about clean linens, limiting bathing privileges to cut the water bill-eliminating the concerned treatment offered by Mrs. Padilla and Mrs. Anaya.

"I have a feeling the profits are quite large," said Adelina Hill, a social-work professor at Highlands University in Las Vegas and a former adult specialist with the state Health and Social Services Department (HSSD).

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