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, probably— do 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-administered 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 soup; 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."

[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, said 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).

"You can run a boarding home in a house that would be nearly condemned anywhere. We have a home here (in Las Vegas) where there are four men living in a trailer the owner bought for $50.

"For what some of these homes are providing, they shouldn't get more than $1 a night."

Lt. Paul Adent of the Albuquerquè Fire Prevention Bureau said, "They must be making money. We've seen them put in $10,000 worth of improvements immediately after one of our inspections."

There are many stories of exploitation in boarding homes.

An HSSD worker tells, for example, of operators who "buy one newspaper and charge everyone in the home 10 cents for it, or who charge extra for the use of the telephone."

Such situations have become particularly common, she said, since the federal takeover of aid to the elderly and disabled, as the federal regulations contain no provision to prevent operators from taking every cent of the welfare recipients' checks.

Larry Brown, state director of the HSSD Social Services Agency in Santa Fe, said caseworkers around the state have been reporting frequent instances of operators eliciting the full sum of their welfare boarders' monthly checks, leaving those persons no money at all for personal expenses.

Mr. Brown said he would like to see all charges for boarding-home services posted in the homes to prevent unscrupulous padding of fees, but said, “Our only authority is persuasion."

Armando Griego, director of the HSSD Public Assistance Agency for south Bernalillo County, said however, that he is attempting to work out a voluntary agreement with boarding-home operators whereby they would leave their welfare clients some money for personal use, and not take the full $140 from them.

Despite the many tales of seemingly deliberate neglect and exploitation in boarding homes, however, there is at least one person who believes that some of the conditions in boarding homes may stem from ignorance.

"Many boarding-home operators have no knowledge of financial management, or of dietary management," said Dr. Robert McCarthy, a psychologist with the Bernalillo County Mental Health Center, who periodically works in several of the homes.

Dr. McCarthy does acknowledge some "less than adequate" situations in boarding homes, and he does not offer his explanation as a justification for those situations to continue.

He proposes, however, to take a "positive approach," as he calls it, and to that end he is applying for grant money to set up a model boarding home where the real needs and inadequacies of boarding homes could be studied, and the operators trained.

Boarding homes are not a new problem.

"We fought it for 12 years," said Mr. Kneafsey of the Environmental Health Department, which stopped making regular inspections of boarding homes about two years ago.

It might seem that the families of old people would have demanded action on the boarding home situations, or the residents themselves.

And there have been complaints.

But for the most part, both those groups probably have helped perpetuate conditions in the homes.

The families of people in boarding homes, it seems, are not much different from the rest of society, which has allowed conditions to remain as they are for so long. Joan Tefft, county supervisor of adult services with the HSSD Social Services Agency, said reasons given by people who come to her seeking placement for their elderly parents often are: "She's too much trouble," or "My husband says he's going to leave me if my mother is in the house one more day."

Many of the families, quite simply, do not want their old or difficult relatives, and do not really care what happens to them once they are out of sight. Why then don't the residents complain, or just move out?

Many of the mentally ill or retarded ones are incapable of taking action on their own behalf.

And that situation may also apply to some of the old people.

But with many others, the obstacles are more complex.

"They are afraid," said one state official. "Afraid of losing what little they have, or afraid of the boarding-home operator, or just of the unknown."

Feeling rejected, in many cases, by their families, they feel "lucky to have a roof over their heads," said Albert Sanchez, staff social worker at Bernalillo County Medical Center.

After the recent arrest, for example, of the proprietor of a South Valley boarding home for allegedly beating an 82-year-old woman, state and county officials revealed that they had received complaints of mistreatment in that home before. In each previous case, however, the officials said they were unable to get testimony from any of the aged residents of the home.

Dr. McCarthy tells of a woman in one boarding home who bore bruises from beatings by the operator of the home.

He talked to her, he said, about moving, but the old woman didn't want to leave the friends she had in the home.

In addition, he said, she told him that her family lived just down the street where she could walk to visit them, and that she felt if she moved, they would never come to see her.

And so the poignant fears of the old people themselves are a part of the sorry web of circumstance that makes many of their lives so miserable.

"They feel like they're in prison once they go into a boarding home," said Ms. Tefft of the Social Services Agency.

"But they're not. If they would just call us...."

[Albuquerque Tribune, May 15, 1974]

FIVE AGENCIES AUTHORIZED TO INSPECT-BUT THERE'S CATCH-22

(Third in Series)

At least five state and local agencies are authorized to inspect boarding homes for the elderly and mentally handicapped in Bernalillo County.

Any one of the agencies has the power to shut down a boarding home on one ground or another-for failure to meet complex fire and safety regulations, food regulations, health regulations or any number of other regulations.

And there are educated guesses from within the agencies themselves that they could move in and shut down almost every boarding home in the county.

Yet within the past two years, the total number of boarding homes closed by official action probably could be counted on the fingers of two hands.

The catch-22 kind of reasoning that brings responsible officials to blink at open examples of filth, abuse, neglect and exploitation in boarding homes is circular and self-defeating.

The agencies, in their wisdom, have recognized that certain minimum standards must be maintained in order to support the health, well-being and the very survival of the residents of boarding homes.

Yet none of the agencies has provided for alternative housing in cases where the boarding homes fail to meet those subsistence standards.

The prospect of taking in old and mentally handicapped people apparently is not appealing or lucrative enough to attract large numbers of private individuals willing to operate top-quality boarding homes.

And the state, county and city themselves have not seen fit to establish any facilities to house that group of people.

So when outraged observers of boarding homes cry "Do something!" to public officials, the officials lamely answer, "What can we do? There's no place else to put them."

Of the five agencies authorized to inspect boarding homes-the state Health and Social Services Department (HSSD), the city Environmental Health Department, the city Housing and Development Department, the county Fire Marshal's Office and the Albuquerque Fire Prevention Bureau-only the last on the list has shown much inclination to act against the homes.

Most of the closings over the past two years, in fact, have been the work of the Fire Prevention Bureau.

But some of them have been accompanied by tear-jerking media accounts of homeless old people being cast out into the streets, and the Bureau, not the negligent boarding-home operators, emerged as the villain in those accounts.

There are other factors which contribute to the state of inaction on boarding homes.