Deficient conditions found in Nevada’s homes for mentally ill

Legislative auditors on Wednesday painted a horrific picture of conditions in Nevada’s community-based homes for the mentally ill, saying there were seriously deficient conditions in all 37 of the homes inspected.

Auditor Todd Peterson said his team found extremely unsanitary conditions in 36 of them, health and safety hazards in 34, fire hazards in 33 of them and poor medication management in 28.

In 11 of the 20 Southern Nevada group homes inspected, he said the staffer identified as the caregiver spoke little or no English, “the language of the clients living in the home.”

He said auditors found mold and mildew, rodent and insect infestations, human waste and expired food as well as broken, leaking toilets and broken windows.

Peterson told the audit subcommittee those conditions were despite the fact the state pays an average of $1,450 a month per client to private operators to provide those mentally ill adults with housing and other services. The state funds a total of 105 such homes with an average of four clients living in each of them.

“This is failure,” said Sen. Ben Kieckhefer, R-Reno. “Taxpayers are basically paying slumlords to warehouse mental illness.”

“I hope you’re all as disgusted as I am,” said Assemblyman Jim Wheeler, R-Minden. “I wouldn’t put my dog in these conditions.”

Peterson also said even though inspectors from the Division of Adult Mental Health Services were in some of the same homes just a week or two before he and his auditors toured them, those inspectors failed to document many of the problems and violations his team reported.

Administrator of the program Amy Roukie told the subcommittee what the auditors found is, “as shocking to us as they are to this committee.”

She said they’ve now created quality assurance teams responsible for overseeing the community homes and reporting all the issues they find.

But subcommittee Chairman Assemblywoman Teresa Benitez Thompson, D-Reno, and Kieckhefer asked what has changed since then.

Roukie assured lawmakers things are much better now than they were in November when auditors visited them. She said all are now being inspected monthly. She said the division is now being proactive inspecting the homes and holding operators to their contracts to provide safe living conditions for those clients.

She told the subcommittee one of the division’s problems is finding providers who will accept these patients. She said the concern is there aren’t enough providers.

Carlton and Wheeler both asked if there are possible criminal penalties for mistreatment of these clients and some way to “claw back” the money the state has paid some of the worst operators.

“To me this shows that privatization sucks,” said Assemblywoman Maggie Carlton, D-Las Vegas. “There has to be a penalty, has to be consequences. You can’t treat people this way and the fact they’ve got us over a barrel is even worse.”

She said maybe the state needs its own system, “so we don’t have to rely on these terrible companies.”

Roukie said new laws passed in 2017 should also help the division get a better handle on these homes by requiring all the community homes be inspected and certified.

Altogether, the state spends $134 million to provide housing and residential services by contractors who operate the community homes.