Tax-supported agencies send mentally ill to unlicensed homes

ATLANTA - State supported agencies that oversee care for mentally ill Georgians sometimes refer them to unlicensed personal care homes that operate without any state oversight, The Atlanta Journal-Constitution reported Sunday.<br /> <br /> In an article examining the death of a 61-year-old woman at one such home, the newspaper reported that the state Department of Human Resources cannot say how many unlicensed homes are operating.<br /> <br /> The newspaper said the homes become a last resort for mentally ill adults who rely on government disability or Social Security benefits to pay their rent and other expenses.<br /> <br /> According to the newspaper, state regulators responded to 98 complaints about unlicensed personal care homes in the fiscal year ending June 30, and substantiated complaints in 37 cases, but issued fines against only three.<br /> <br /> The newspaper examined Patricia Cipolla's death on Labor Day at an unlicensed home called Wellness Retreats in Atlanta.<br /> <br /> A medical examiner said Cipolla had been dead eight to 12 hours by the time she was found in her room. An autopsy determined she died of hypertensive cardiovascular disease. Records from the pharmacy and from Cipolla's Medicare prescription plan show her blood pressure prescription was last filled in May, nearly four months before her death.<br /> <br /> The newspaper said it could not determine whether Cipolla received that or other prescribed medications. But it said a licensed home would have been required to keep records of medication.<br /> <br /> By the time Cipolla moved there in October 2006, she had a long record of multiple hospitalizations for bipolar disorder.<br /> <br /> She was referred to the home by Georgia Rehabilitation Outreach Inc., an Atlanta-based nonprofit that gets state money - about $13 million since 2002 - to oversee the care of mentally ill adults.<br /> <br /> It is one of three private agencies with state contracts to provide a range of treatment to more than 400 mentally ill adults. The others are in Thomasville and Athens.<br /> <br /> Chief executive Shirley Hamilton said about one-third of Georgia Rehabilitation's 200 clients live in personal care homes or similar facilities. She said neither her agency nor the state checks whether the homes are licensed.<br /> <br /> Audrey Sumner, the state's director of mental health services, declined to comment on Georgia Rehabilitation's handling of Cipolla's case.<br /> <br /> Cipolla's daughter, Tina Kreutzer, filed a complaint against Wellness Retreats with state regulators. The department told Kreutzer in a letter that, "Based on the investigative findings, the allegation was unsubstantiated and no violations were cited."<br /> <br /> A state investigator later issued a citation for operating illegally with no license. The state told Wellness Retreats's director, Michelle Edmonds, to apply for a permit or close by Dec. 29.<br /> <br /> Edmonds declined to be interviewed by the Journal-Constitution. In an e-mail responding to a reporter's written questions, she described Cipolla as being "known in the field as a very difficult consumer" who "was on a first-name basis" with psychiatric staffs at Grady and Georgia Regional Hospital/Atlanta.<br /> <br /> The newspaper reported that Wellness Retreats' most recent location is now empty, and that Edmonds declined via e-mail to say where the residents had gone. Wellness Retreats, she said, is "in transition."<br /> <br /> The article was part of a yearlong investigative series in the Atlanta