NEW YORK

A major issue affecting people with disabilities in New York throughout 2002 and 2003 was housing for the mentally ill, which received widespread public attention, in part because of newspaper stories about substandard care for this population in adult homes. A special administration task force was established in May 2002 to review the existing system, and in November 2002, several New York state agencies announced a series of actions to ameliorate conditions for the mentally ill in adult homes.

In 2003, both the Pataki administration and several key legislators proposed measures to provide greater legal protections for residents of adult homes, to increase penalties against homes cited for violations, and to otherwise tighten oversight of the homes. However, none of the measures was enacted.

In July 2003, Disability Advocates Inc. filed a complaint in District Court, claiming that the placement of people with mental illness in adult homes violated the Americans with Disabilities Act (ADA) ".... by causing their needless institutionalization in substandard facilities when their needs could be more appropriately and effectively met in integrated residential settings." (See Status Report: Litigation Concerning Medicaid Services for People with Developmental and Other Disabilities by Gary A. Smith at http://www.hsri.org/index.asp?id=news.)

The plaintiffs charged that "impacted" homes (facilities in which 75 percent or more of the residents are mentally ill) are segregated institutional settings that fall under the purview of the ADA and the Olmstead decision. The lawsuit targeted 26 adult homes in New York City where an estimated 4,000 people with mental illnesses live. The plaintiffs asked the court to order the state to expand the availability of "supported housing" and to improve conditions in adult homes. The state's response on October 1, 2003, disputed all the allegations, arguing that the plaintiffs lacked standing to bring the complaint, and that state agency personnel had not determined that the adult home residents in question were appropriate candidates for a more integrated community setting. The state also argued that providing the supportive housing sought by the plaintiffs would involve a "fundamental alteration" in services, an action that the Olmstead decision does not require states to take.

In other actions, the New York Office of Mental Retardation and Developmental Disabilities announced that after five years, the state's NYS-CARES program (New York State Creating Alternatives in Residential Environments and Services) had provided residential services to more than 7,000 individuals. As the program reached the last year of its five-year duration, the state began a new initiative, NYS-CARES II, which is expected to add 1,900 residential options during the next 10 years; it also would increase day services and family support services.

The Pataki administration also announced new regulations in July 2003 to require non-licensed direct care homes and home care staff to undergo criminal background checks. The proposed regulations also prohibit prospective employees who have been convicted of specific felonies involving sexual assault, drug trafficking, and grand larceny, among other serious crimes, from working in nursing homes or for home health agencies. In January 2003, the Department of Health implemented a requirement that certified nursing assistants currently working in nursing homes indicate as part of the re-certification process whether they had ever been convicted of a crime or charged with a crime that did not lead to acquittal or dismissal.

In 2002, the New York legislature called for the creation of an Olmstead task force, the "Most Integrated Setting Council," but the executive branch had not appointed members to the council as of fall 2003.