Of all the different housing solutions available to the most vulnerable among us, Adult Residential Facilities (ARFs), or Board and Care homes as they are more commonly known, can be the most effective. This is precisely because they are intended to provide the kind of 24/7 support and care that people who have experienced homelessness, substance use disorder and/or mental illness most need.
Depending on the level of need in the populations they serve, Board and Care facilities can offer a wide variety of services, including:
- Assistance with activities of daily living (ADLs), such as bathing, dressing, and eating
- Medication management
- Meal preparation and service
- Social and recreational activities
When sustainably funded and managed properly, Board and Care homes are literal life-savers, offering their clients the kind of care, treatment and support they need to enjoy healthy, fulfilling lives. Because of the many services Board and Cares provide, their clients also experience a number of meaningful benefits, chief among them:
- Personalized care: because the facilities can be small, staff can provide more hands-on care to each resident.
- Home-like environments where residents can more easily feel comfortable and relaxed.
- Socialization: Board and care clients have opportunities to form community with their fellow residents
Two great examples of Board and Care facilities in the Hollywood area are the Bel Air Guest Home and Anew Dawn Adult Living. Bel Air offers vital support to 65 residents, many of whom were formerly unhoused, living with mental illness and substance use issues. One of the jewels of care at Bel Air is their community garden, which gives residents the opportunity to work together in beautifying their collective home.
Anew Dawn has 94 beds and prides itself in offering their residents a safe transition from homelessness to a healthy community. Anew Dawn is one of the newest assets to come online through the innovative Hollywood 2.0 pilot program, which has helped support the “highly enriched residential care” found at Anew Dawn.
While Bel Air and Anew Dawn are glowing examples of Board and Care success, they are the exception in Los Angeles County where more often than not Board and Cares are under-funded and under-acknowledged as part of our regional continuum of housing and care.*
This unfortunate reality has been highlighted in a recently released report from professional researchers, Aimery Thomas and Leila Towry of The Future Organization (TFO). The report (which can be found on the Resource page of Hollywood 4WRD’s website) is entitled, Serving Our Vulnerable Populations: LA County Adult Residential Facilities and Residential Care Facilities for the Elderly. As TFO describes it, “This first of its kind, county wide study on care facilities provides critical insights, data, and recommendations to inform a more seamless continuum of care and the alignment of health, mental health, and housing resources, not only here in Los Angeles, but hopefully across the State.”
Below are just a few of the many ‘critical insights’ offered by TFO’s study:
- Too many beds are vacant: During the study period (July 2022 through November 2022), owners and operators of Market ARFs and RCFEs identified that 25.9% of their resident bed capacity was vacant or underutilized (approximately 6,400 beds), with the majority of underutilized beds located at RCFEs.
- Additional actions are required by government and nonprofits to fund and activate many potential placements.
- Operators are willing to accept new resident RIGHT NOW: Opportunities exist for government agencies and nonprofits to deliver wraparound services to greater numbers of facilities in the Market, as well as ensure more equitable balance in the geographic distribution of services to facilities across the entirety of Los Angeles County and its Service Planning Areas (SPAs).
- Improving access to and distribution of government and nonprofit wraparound services to Market facilities in all County localities will provide enhanced care outcomes, enhance rates of graduation to lower levels of care, and assure more consistent quality of life for residents from the identified, vulnerable population.
- There is no flow between levels of care: Low proportions of residents graduate from Market facilities to lower levels of care (12.9%), such as permanent supportive housing or affordable housing, indicating potential gaps in government and nonprofit wraparound training and education services that could enable more resident movements.
- Reduced rates of graduation to lower levels of care for existing residents capable of doing so is a key structural impediment preventing more efficient and effective use of the Market’s limited ARF capacity.
Despite the stark realities their report has uncovered, Leila from TFO is hopeful that their report can be used as a vehicle for change. “The Future Organization is optimistic that this study will provide system users and key stakeholders working to end homelessness with evidence from which to create more resources, support, and opportunities for facility owners and those they serve.”
If key decision makers and leaders of public policy were unaware of the many opportunities available to strengthen the system supporting Board and Cares (and the many clients they serve), they shouldn't be after reading this report. As H4WRD’s Executive Director, Brittney Weissman sees it, TFO’s comprehensive study “is essentially a playbook for how to make change.”
As the examples of Bel Air Guest Home and Anew Dawn illustrate, Board and Cares offer residents the opportunity to receive care, compassion and community they couldn’t find elsewhere. But as the TFO study makes abundantly clear, these facilities are facing perilous challenges as currently funded (or not) by the existing health care system. It will take all of our collective advocacy to save and enhance Board and Care homes, and to ensure that this essential housing option can continue to improve the lives of the most vulnerable among us.
* Because of the lack of necessary funding, Board and Care homes can also be extremely difficult to operate. This challenge is beautifully and heartbreakingly covered in “Suffering in Silence”, a recent interview conducted by Kerry Morrison (Founder of Heart Forward LA, and one of H4WRD’s Founding Board Members) with Rhoda and Gochin, an amazing couple who share their journey operating a board and care home in the San Fernando Valley for the last 22 years.
Download TFO Study HERE
Additional articles on this topic:
- LA Times: Board and care homes could make a dent in homelessness but remain underfunded, study finds
- LAIst/Opening of Bel Air’s Community Garden: At This Hollywood Home For People Living With Serious Mental Illness, ‘Gardening Is Like Therapy’
- LA Times: Homes for people with severe mental illness are rapidly closing. Will help come fast enough?