Four hundred and twenty-seven residences in the city have the facilities to offer room, board and in some instances personal care, to 2,690 blind, elderly, mentally ill and retarded, adults who are able to live in the community, according to a recent report.
Despite their availability, however, the residences are underused, and patients who would benefit from community living are still confined in large city institutions, the study said.
Last fall a survey of patients at St. Elizabeths Hospital, the city mental health center, revealed that 259 of the patients needed independent and minimally supervised living accommodations in the city. Vacancies then available in the 427 facilities might have accommodated them all. The report said, however, that "there may be problems in keeping a high occupancy level in these residences (because) some residences are under agreement with a single placement agency and may not fill vacanies with other agencies' alients.
The nine-month research survey was conducted by the D.C. Municipal Research Bureau through telephone interviews.
Deborah Rodock Maiese, assistance director of the agency, said the impetus for the research was the need for a residential referral list to help city and federal government agencies locate small community residences for patients now residing in large, impersonal institutions.
"Mental hospitals have an increasingly elderly group that have been there 25 or 30 years," said Maiese. Some of the residents have never cooked a meal, taken care of a home or undertaken any independent action, she said. More than lacking the ability to do these things, they have lacked the opportunity, she explained.
The bulk of available housing is in foster care placement and rooming houses, said Maiese. Within the city there are 88 rooming houses or formerly private homes now licensed as rooming houses because they have six or more unrelated persons living together, she said.
"Most of the 88 places are small," with six to 10 people living together, she continued. A good many of the homes are run by elderly residents who take in the boarders for companionship and to supplement their own fixed incomes.
"One of the ladies in the study was 92 years old," said Maiese. "She'd been in the business during the last 30 years."
At present there are no legislative guidelines monitoring the quality of the homes, she said. However, the city has passed a Community Residence Facilities Licensure Act, and a staff will begin implementing it in September. The staff will license, monitor and eventually list all community residence, excluding single dwelling units, with a Central Referral Bureau.
Among the act's provisions are requirements that the homes have smoke detectors, clothes bureaus to hold personal belongings, rooms divided by partitions, clean linen, three nutritious meals daily and social privileges, such as the use of the telephone.
Many of the existing homes are concentrated in "the Mount Pleasant, Adams-Morgan areas and hugging the east side of Rock Creek Park above Columbia Road," said Maiese. The concentration sparked many citizen complaints to the D.C. Zooming Commission, which eventually asked the members of the Department of Human Resources and the Municipal Planning Office to appear before the commission to reply, she said.
Representatives of the city agencies said that present zoning restrictions do not allow single-family homes to be used for residential care programs. Instead these service exist in the neighborhoods with row houses and apartment complexes. A more equitable distribution of community-care programs could be reached, they suggested, if the area west of Rock Creek Park was opened by lifting this restriction.