“I didn’t know much about it. That’s why I got out of it,” says Westbrook, who says she withdrew from thebusiness after about a week. “They started something, but they didn’t know what they were doing.”
Other states have strict rules regarding regulation of group homes.Florida, for example, requires all homes providing mental health services to be certified by the state andto have a nurse on staff.“I think there is somewhat of an understanding, at least in Florida, if you put your loved one in a facilitywith a license…there’s at least some minimum standards of oversight for those facilities,” says Dr. J. PaulRollings, a regional director of mental health services for Florida's Department of Children and FamilyServices.New York’s laws dictate homes providing services to five or more unrelated people be licensed, andrequire swift notification of missing residents.Michigan outlines the duties expected of staff members at so-called adult foster care homes.In Illinois, several agencies share regulation of homes for the mentally ill.The Illinois Department of Public Health certifies homes that include nursing care. The Department of Human Services certifies nearly 2,500 homes that receive state and federal dollars to care for thementally ill, but does not license those that receive no government money. The Department of Childrenand Family Services certifies foster homes and day care for children.Cathy Cumpston, chief of DHS's Bureau of Accreditation, Licensure and Certification, says it’s notuncommon for group homes in Illinois to operate with no oversight.“Quite often in settings where people with mental illness live, there’s no licensure from (the Department of Public Health). DHS has no licensing standards for homes for people with mental illness,” she says.The state does not allow hospitals to discharge mental health patients to unlicensed group homesbecause they are “are not adequate for provision of mental health care,” says Dan Wasmer, actingregional director of DHS's mental health division.But it does not stop such homes from caring for other patients outside of government-funded programs.“A person can say they provide (mental health services) and charge somebody for it, but if the person’swilling to pay for it directly, they don’t have to be involved with (the mental health department) at all,”Wasmer says.
Mental health advocates say the state's patchwork of regulation allows the operation of rogue homes,which receive no state or federal money and can operate by their own rules, sometimes to the detrimentof mentally ill residents.“What they amount to is really unregulated boarding homes,” says Zipple, the Thresholds CEO.