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Mental Health, Story Two: Who's In Charge?

By Kelley Weiss


Kansas City, MO –


KCUR has reported on the story of a woman who died in a group home near Kansas City three years ago as one tragic illustration of a mental health care system in crisis. In the second report in our series KCUR's Kelley Weiss looks at money mismanagement in group homes and who's responsible for watching over these facilities.

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Looking at a handwritten ledger with hardly any details Jackson County Public Administrator, Rebbecca Lake Wood, says it's shocking that a facility would keep track of resident's money like this.

Rebbecca Lake Wood: "So for example I'm looking at the personal spending for this one individual for July of 07. It simply says personal spending, bus pass or cigarettes...there is one receipt for probably cigarettes. But I don't see a bus pass receipt. And, as far as the personal spending, it's a varying amount and really no way to know if it's true or not."

As an attorney and guardian of more than 500 mentally ill clients Wood manages their money and finds places for them to live. Wood says the group homes her clients live in often mismanage and sometimes steal some of the $1.5 million the Department of Mental Health dedicates for residents' personal allowance. And, she says, to make it worse it's taxpayers' money.

Wood's office investigated the bookkeeping of one Kansas City facility - New Horizons - and determined staff was misappropriating money at the residential care facility, or RCF.

Rebbecca Lake Wood: "They didn't have enough cash in their pocket to pay the bills of the RCF, so they took the money belonging to the patients. They took their $30 or their $60 or whatever small amount of monies they were entitled to."

Wood says the facility has since returned the $15,000 of missing money and she plans to give her investigation of New Horizons to the Jackson County Prosecutor's Office.

Adrienne Edmondson recently took over New Horizons as interim executive director and she says this practice of money mismanagement will not be tolerated, saying under a new policy her facilities will not hold more than $200 per resident. Wood says the real problem, though, is it's unclear who is protecting residents' resources. One of the reasons it's confusing is because oversight of the mentally ill is split between two departments.

Keith Schafer: "It is a challenge and it's what makes the average citizen frustrated because it's like who's on first, who's responsible?"

That's the director of the Department of Mental Health, Keith Schafer, one of the two departments that regulates group homes. Schafer says the problem is that his department licenses only a small percentage of group homes whereas the Department of Health and Senior Services, or DHSS, licenses all the facilities and inspects them for safe living conditions, management of medications and oversight. If the facilities don't meet state regulations DHSS cites them and writes a report called a statement of deficiency.

But advocates for the mentally ill say citations are not enough. DHSS records reveal several common ways facilities cheat the mentally ill: they don't keep individual accounts, they use residents' money to pay the bills or sometimes steal tax refund checks.

In one example, according to the records, the state cited a Liberty facility, The Cedars of Liberty, in 2006, for depositing almost $22,000 of its residents' tax refund money into its facility operating account. The Cedars appealed this violation. The state denied the appeal, made The Cedars return the money, but imposed no fine. Wood laughs at this leniency.

Rebbecca Lake Wood: "In my mind they are using a feather duster when they ought to be using a hammer on these agencies. You don't hear of fines or licenses being taken because they rip off their clients."

State officials in charge of monitoring these homes are hesitant to take responsibility for these problems. But, a review of hundreds of pages of DHSS reports show repeated violations.

Jane Drummond: "We walk a fine line we definitely want a facility to comply with the standards that are in the law."

That's Jane Drummond, director of the Department of Health and Senior Services. She says it's hard to enforce regulations. But, back to Keith Schafer at the Department of Mental Health - he says he looks to Drummond's department to crack down on residential care facilities, or RCFs, for mismanaging money.

Keith Schafer: "We can't shut that program down because we're not programmatically controlling them. Jane on the other hand, health and senior services, if they make these citations they can withdraw the license of an RCF if they find that it's deliberate abuse and mismanagement of client funds is clearly an issue. If it were deliberate mismanagement I'm sure health and senior services would come down on that big time."

Jane Drummond: "We also don't want to be in the business of coming in and shutting down facility after facility and resulting in a situation where many of these people frankly might end up on the street."

But, Rebbecca Lake Wood rejects this argument. Wood feels the state reacts to widely publicized events like the fire at the Anderson group home last fall that killed 10 residents while ignoring ongoing misuse of money.

Rebbecca Lake Wood: "You don't see that kind of excitement and uproar about the theft of poor people's money and that is what I'm appalled at."

While it's hard to point the finger at one department, Wood wants to know who's going to break down this web of bureaucracy and protect the few assets these vulnerable people have.

Funding for health care coverage on KCUR has been provided by the Health Care Foundation of Greater Kansas City.

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