'No oversight' for unlicensed homes

A licensed personal care home gets inspected every year by the Georgia Department of Human Resources. It receives quarterly visits from the state's long-term care ombudsmen. It must post a bill of rights,  instructing residents how to file complaints about the quality of care or living conditions.

     None of that is true for unlicensed homes.

     An unknown number of unlicensed homes --- possibly in the dozens --- operate across the state,  according to advocates for people with mental illness and disabilities and the elderly.

      A license does not guarantee better care. But with unlicensed homes,  "there is no oversight,  no minimal standards, " says Becky Kurtz,  the chief state ombudsman for 13 years,  who is on leave until June. "If the provider does something harmful,  there's no recourse for the resident,  unless it's criminal."

     A facility that offers even one "personal service, " such as supervision of residents' medicines,  is required to obtain a state license. Boarding homes,  which provide nothing more than meals and a place to sleep,  may operate without one. Although some unlicensed homes advertise themselves as "assisted living" facilities,  the law does not distinguish them from personal care homes.

     The state may fine an unlicensed facility as much as $25,000 or shut it down.

     Regulated homes operate with a degree of transparency that is absent from unlicensed facilities. Inspection reports are posted on the Internet,  as are the rules that such homes must follow.

     Those homes are "better prepared to deal with the issues our people go through, " says Wanda Francis,  chief executive of Diversified Family Solutions,  a case management agency in Decatur.

     "Any day I'd go with the licensed people, " Francis says. "It's a whole other ballgame. The standards are way,  way better."

     But Francis' agency,  like others,  has directed a few clients to unlicensed homes. Residents generally pay their rent with their government disability or Social Security benefits. But because the homes don't directly receive state money,  the Department of Human Resources does not require case management agencies to report such placements.

     Sometimes,  an unlicensed home may be the only option.

     "There's always a need for more space" for mentally ill adults,  says Jade Benefield,  director of Clayton County Mental Health,  Addictive Disease and Developmental Services.

     As Francis puts it,  "Where else are you going to put people?"