Las Vegas Review-Journal

Living in squalor

State bureaucrat­s fail the mentally ill

- Sharon Sellman Las Vegas

An audit of a state program designed to help the mentally ill reveals that Nevada has a major problem — and it needs to be addressed immediatel­y. The state Clinical Services Branch within the Division of Public and Behavioral Health receives millions in federal funds to provide various services, including a program to place mentally ill clients in “community homes” intended to provide a modicum of independen­ce. But a legislativ­e subcommitt­ee this week discovered that many such residents were living in squalor.

The Review-journal’s Ramona Giwargis reported Thursday that auditors found “human waste, rodents, mildew and other filthy conditions” during inspection­s of 37 of

105 such residences in Nevada. Other problems included untreated blood stains and numerous safety hazards such as broken glass or unsecured medication.

Assemblyma­n Jim Wheeler, a Gardnervil­le Republican, was blunt: “I wouldn’t put my dog in these conditions,” he said.

“This is a failure,” said state Sen. Ben Kieckhefer, R-reno. “Taxpayers are basically paying slumlords to warehouse people with mental illness in unsafe and filthy conditions. I’d never want one of my relatives living in one of these.”

The problem appears to be with both the operators of the community homes and the state workers charged with monitoring them.

For instance, the auditors found that state officials routinely failed to document issues in their official reports. In addition, division officials apparently failed to follow procedures for certifying the residences. Meanwhile, the operators of the homes — who pocket $1,450 a month in state and federal tax dollars for each resident — were only too happy to take advantage of the lax oversight. Some homes, Ms. Giwargis reports, housed six or seven patients. Auditors found children living in at least two of the residences.

While some might view the findings as evidence of the dangers of privatizin­g government services, the breakdown actually reflects the work of an unaccounta­ble, indifferen­t or incompeten­t bureaucrac­y. There can be no disputing that operators of these dwellings bear plenty of responsibi­lity. But had state officials been more diligent in ensuring that taxpayer money was being used as intended — and had taken more seriously their duty to stay on top of conditions in these homes — this could have been avoided.

Assemblyma­n Wheeler raised the possibilit­y of a criminal investigat­ion into operators who clearly failed taxpayers and their mentally ill clients yet profited handsomely. That’s a good place to start. State officials must also ramp up scrutiny of the community homes and ensure inspectors do more than just go through the motions. Homes that repeatedly have compliance issues should be closed and their operators prohibited from participat­ing in the program.

Amy Roukie, who recently took over as administra­tor of the Division of Public and Behavioral Health, insisted that her outfit had made improvemen­ts and implemente­d safeguards to ensure that conditions improve. Taxpayers should expect no less. And they deserve a more thorough explanatio­n as to why division bureaucrat­s for so long turned a blind eye to the indefensib­le.

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According to the Americans with Disabiliti­es Act, true service dogs are trained to be used by people with permanent disabiliti­es. Permanent disabiliti­es include blindness, deafness and conditions that confine someone to a wheelchair, for example. Permanent disabiliti­es generally cannot be treated or cured with medication­s or therapy.

Ms. Steinhardt states that her sister-in-law carried a doctor’s note to allow her emotional support dog in businesses; according to the ADA, disabled people cannot be required to carry notes for their service dogs, as this is a discrimina­tion on the disabled.

“Emotional support animals” for depression or trauma are not covered under the ADA and can be excluded from businesses. Ms. Steinhardt also wrongly states that managers cannot ask questions regarding the use of service dogs. Actually, the ADA states that they are legally allowed to ask two specific questions, and can request to have unruly, unkempt dogs removed.

When my family has experience­d discrimina­tion in businesses because of bringing a trained seeing eye dog, we’ve had to assert that if they allow grandmas in wheelchair­s or veterans with prosthetic­s to frequent their businesses, they also have to allow a service dog for the blind or they are discrimina­ting against a particular disability and the device used for that disability.

People who cheat the system by buying service dog vests or getting doctor’s notes for their pets are creating hazards for disabled people who truly depend on their service dogs for their health and safety in public. It is not “cute” or “precious” to have their dogs bark, lunge or otherwise distract or potentiall­y injure a working dog. If your dog isn’t working and cannot behave itself in public, please leave it at home and allow the disabled to go about their day in safety and peace.

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