Third of a four-part series.
PART 1: Cleaning Up: Federal money is expanding drug treatment in Baltimore--and causing providers headaches. 06/22/2010
PART 2: Old Habits: Medicalization is the hot new thing in drug treatment. Just like in 1970. 07/27/2010
PART 4: Waiting for the Plan: As more money flows into drug treatment centers and the number of addicts rises, Baltimore can't determine which programs actually work 11/10/2010
Providing housing to recovering addicts was good business for Mark Anthony Spence—for a while. In late February 2009 he listed his income at $24,199.08. Per month.
In 2008, Spence grossed $330,000 from Baltimore Behavioral Health, Inc., the nonprofit drug treatment center that dominates street life in the west side neighborhoods around the B&O Railroad Museum, for providing housing to recovering addicts. The year before, in 2007, Spence reported a gross income of $457,400.
Somehow, it wasn’t enough.
Spence disclosed his finances in a bankruptcy filing, which was discharged May 12, 2009. Spence and his wife lost their home, a stone-faced, 6,700-square-foot McMansion with a four-car garage in Bowie, for which they had pledged $1.4 million in 2007.The bankruptcy papers reveal that Mark’s wife Cathy brought home about $3,800 per month working for Comcast. They claimed a $2,789 monthly bill for the mortgage on a “Baltimore property.”
By far, though, the Spences’ largest monthly expenditures were related to Mark’s work for BBH, which he listed as his “employer” since 1996. According to the bankruptcy filing, each month the couple spent $13,000 on “rent for Baltimore Behavioral.” With utilities, water, and maintenance costs added, the couple’s BBH expenditures summed to $20,400 each month.
Spence’s bankruptcy raises questions about how recovering addicts are housed, who pays, and how much. The answers are hard to come by. Spence could not be reached for comment; people in the neighborhoods surrounding BBH say they’ve never heard his name. And Terry Brown, BBH’s vice president of resource development, says the nonprofit, which collected $17 million last year from taxpayers to provide drug treatment to about 500-600 patients at any given time, never employed Mark Spence, and is not in the housing business.
“From our perspective, we didn’t think we’re going to spend hundreds of thousands of dollars for this particular vendor,” Brown says. “Mark was just one of the persons who was interested in leasing a bed to us.”
Leased beds, starting at about $10 per day, are at the center of the huge, secretive, and unregulated business of providing housing for recovering drug addicts. Formerly known as “recovery housing,” the new term is “supportive housing,” housing specialists say. Every week in Baltimore City, dozens of people with substance use disorders are referred to such houses as part of their treatment, or upon discharge from treatment programs. Often they pay as much as $100 per week to a landlord—who is sometimes a former addict—to live in a communal setting with other recovering addicts. As of 2005 there were perhaps 20,000 people living this way in Baltimore, according to one estimate. Some of the homes are lifesavers, with strict rules, strong managers, and crucial services. But many are unstaffed, with few or no house rules, and appear to facilitate relapse.
On July 1, for the first time ever, the Maryland Alcohol and Drug Abuse Administration authorized the use of state taxpayer money to fund supportive housing as part of the move toward what drug treatment professionals call the Recovery Oriented System of Care. “This is part of the shift from an acute care to a chronic care model,” Thomas Cargiulo, Director of the Alcohol and Drug Abuse Administration, says. “It’s a way to make the system more cost efficient and more effective.”
Baltimore Substance Abuse Systems (bSAS), the city’s quasi-public drug treatment administrator, will not be funding housing any time soon, according to president and CEO Greg Warren. With a 12 percent cut in the past 18 months, there’s just not enough money, and his office is not staffed or trained to be housing inspectors. Bottom line for bSAS, says Warren: “We are not in the housing business.”
In 1988 the federal Fair Housing Amendments Act gave people with disabilities, including those recovering from substance use disorders, the right to live together as a family. Baltimore’s zoning laws allow up to eight unrelated people to live in any dwelling that could accommodate a family of that size. The Americans with Disabilities Act also prohibits discrimination against people with disabilities or their housing providers.
“The government says that under ADA we must treat people living together in the same house, supporting each other, as a family,” says Tony Harrison, who operated several well-respected supportive homes until the real estate crash and loss of work for his contracting business forced him to close all but two of them. “It’s a double-edged sword, so lots of people opened houses, but there is no oversight.”
During August and September, City Paper called on or visited about three dozen group homes in several city neighborhoods, finding two-thirds of them vacant or boarded up. Getting a look inside the operating houses was almost impossible. In one case, the president of a supportive housing reform organization welcomed a reporter into one of her recovery homes. In every other case, the owner or house manager declined to allow a reporter inside, citing tenant privacy. Most tenants were reticent to speak as well.
The laws protecting disabled people from discrimination do not prohibit their exploitation, and in Baltimore, no institution, public or private, has taken that responsibility. As a result, Harrison says, “the paradigm is cram as many as you can into a single-family house.”
Several men crowd the stoop at 1326 Hollins St., half listening to the boasts of the biggest and loudest one among them. “I’m an expert in demolition, man,” the 25-year-old Troy Blackburn says, spinning a yarn about how he and his crew take three days to “blow up” a building. Blackburn has lived a full life so far, having met the Dali Lama personally, he says. He also says he’s schizo-affective, a diagnosis he received at age seven. He claims to have used every drug “except cocaine and heroin.” He is very glad to be at this supportive house.
“I would recommend this program to anyone who needs help—mental health, drug addiction,” says Blackburn, who has been in treatment since April. “I’d say go to BBH. They help people get their PAC [Primary Adult Care state health insurance], their TEMHA,” he says, using the still common name for the state’s Transitional Emergency Medical and Housing Assistance, now called the Temporary Disability Assistance Program (TDAP).
Blackburn has gone through other programs. Like many people in treatment, Blackburn thinks his current setup is the best ever. “I come to this program, I’m looking for help,” he says. “I don’t know—I’ve been to Sheppard Pratt, a number of times. This is the first time that I’ve dealt with the inner city without being violent.”
Blackburn lived for 30 days in BBH’s Housing Resource Center a few blocks away on Poppleton Street before choosing this house. He pays $203 monthly rent “with my disability” and is the youngest guy in the house, by his own reckoning. He says there are 10 other men living here, paying either $203 per month if they receive a disability payment from Social Security or $153 per month if they receive only TDAP. Food is not included.
With a rent roll between $1,683-$2,233 per month, 1326 Hollins would appear to be a decent investment for its owner, Darmay I. Tolliver, even though she bought near the top of the housing bubble. Land records indicate that she paid $210,000 in 2006, taking an adjustable rate mortgage that started at 8.65 percent. That loan was fully paid off in 2008, and no new mortgage has been recorded.
Tolliver lives in Lauraville and could not be reached by phone. She did not answer her door when a reporter visited in mid-September, nor did she respond to notes left in the doors of her home or the Mercedes convertible parked in her driveway.
Tolliver’s is one of about 10 houses in the Hollins Roundhouse neighborhood associated with BBH. That’s down from at least 23 a few years ago, according to a list provided by a member of the neighborhood association. Of the 23 addresses on that list, only three houses were occupied this summer.Most were for sale. One, 1324 W. Lombard St., was condemned with a collapsed porch. A neighbor says it held at least 25 residents a few years ago.
That Lombard Street house was one of four on the list owned by Cesare Miguel Vaughan. All are in foreclosure, along with several other Baltimore properties Vaughan bought in the mid-2000s. In Vaughan’s bankruptcy filing, he claims assets of about $1.9 million against liabilities of nearly $3.3 million. A message left on his Washington, D.C.-area phone was not returned. In a short interview in 2006, Vaughan declined to spell his name for a reporter, saying that he was “one of those people who always likes to quote-unquote slip under the radar” (“End of Their Scope,” Feature, March 15, 2006).
BBH’s Brown says budget cuts during the past few years forced his organization to scale back on housing for the patients it serves.
“We were getting the level of pay for the level of treatment that was needed,” Brown says, referring mainly to the Medicaid, PAC, and other government transfer payments that enable BBH clientele to receive addiction treatment and other mental health services. “We are no longer able to do that. . . . Now, instead of having a clean bed for a paranoid schizophrenic, we pick them up at the [homeless] shelter in the morning, take them to treatment, then take them back at night.”
He estimates that BBH does that for about 60 patients each day. “For the patients it is stressful, because they have to take all their stuff,” Brown says. “It can’t be left at home and safe.”
BBH takes credit for housing its patients, both in the abstract and in its tax returns, where it claims to have spent some $2.4 million between 2006 and 2009 on patient housing.
Yet when asked about specific providers such as Spence, Brown gets vague, holding him at arm’s length. “It wasn’t by design,” he says of the arrangement with Spence. “It was based on necessity. Then we weren’t able to meet [the patients’ housing] needs—we cut off needing those beds.”
Brown, who has a real estate background, guesses Spence was overextended, but says he has no idea what Spence’s business model was. “We didn’t get that deep into it,” Brown says. “’Cause we’re not in the housing business.”
Although not in the housing business, BBH supplies a handyman who visits the houses its patients live in. “We do repairs because we have to fix up the damage that our patients do,” Brown says. “It’s sort of a net-net lease.”
It’s also a potential $30,000 annual income discrepancy on Spence’s bankruptcy filing, in which he claimed to be spending $2,500 every month on “maintenance for Baltimore Behavioral.”
There are other questionable figures in the filing. Spence’s only Baltimore property, on which he claimed to owe a $2,789-a-month mortgage, was 227 S. Gilmor St., with an outstanding mortgage debt of $137,111.In order for his monthly costs to approach $2,789, Spence’s interest rate would have to exceed 23 percent. According to land records, the actual interest rate on Spence’s primary mortgage was 8.3 percent.
Spence’s numbers don’t quite match BBH’s in another way as well. In his bankruptcy, Spence claims to have grossed $457,400 in 2007.BBH reported paying him $418,012 in that year’s tax form.In 2008, BBH reported paying Spence a total of $410,054,while in his bankruptcy petition, Spence claimed income totaling $330,000.In those two years, BBH claims to have paid Spence $40,666 more than Spence claimed in bankruptcy to have earned.
Multiple e-mails and messages left over two months with Spence’s bankruptcy lawyer, Laura Margulies, and with the bankruptcy trustee, Janet M. Nesse, were not returned. A business partner in a nonprofit company called Hopefinders says he hasn’t seen or heard from Spence in years and doesn’t know his phone number or current address.
Brown says the men to whom BBH paid millions of dollars simply walked in off the street and proposed that BBH send patients to them. “Exactly,” Brown says. “Joy [Smith, BBH’s housing director] would present it to [William K. Hathaway], our CEO, and we see if we can afford it.”
Like Spence, Stephen R. Andrews, 44, who runs a company called Beginning Anew Corp. from his home in Middletown, Del.,also did not return a phone call from City Paper. Land records indicate Andrews owns or co-owns three West Baltimore houses,at least one of which, 533 S. Fulton, had tenants when City Paper visited in August. (A BBH repair technician was working in the house that day.) Andrews and Dan Walker purchased that house in 2006 for $80,000.
From 2007 through 2009, BBH paid Andrews’ company $717,319 for providing housing to its patients.
Squaring these figures with the $153 (or $203) per month BBH patients say they pay to rent rooms is difficult. “If they are in OP [outpatient] or that kind of level of care, in a traditional halfway house, it wouldn’t have anything to do with us,” Brown says. “We don’t take temporary cash assistance, we don’t take food stamps. . . . That’s a misnomer. Those patients are out there on their own. If they’re talking to a guy who rents houses, that’s not part of our transaction.”
He says those patients are even further from BBH’s control, though they might erroneously assume that such properties are BBH houses. “Let’s say I own two or three buildings,” Brown says. “In one I might be getting paid by BBH per bed. In another [patients] might be paying themselves, the patient is in stabilized care . . . the person can still live independent but still in a rooming situation.
“You’re in my second-stage [treatment] house, so the patient doesn’t make that transition in their minds that it’s no longer a BBH house,” Brown continues. “The [landlord] might have a third house and say, ‘Now this is a co-op, and you can live here with one other person.’ The patient still thinks they are a patient of BBH.”
Neighbors of BBH have been similarly unable to make fine distinctions about just who, or what corporation, is responsible for the litter, drug activity, and other quality-of-life issues that have plagued the area. Several say that BBH, while lately responsive to neighborhood concerns, has been less than forthcoming about its housing arrangements.
“They’re kind of very close-mouthed about what they do,” says Peter Hirsch,whose two houses on the 100 block of South Arlington Street stand a block from the massive BBH complex along West Pratt Street. He says conditions have improved over the past few years as the number of BBH patients walking the streets to class and to central meals—what neighbors call “the parade”—has tapered off. Still, “the foot traffic leads to a lot of garbage, a lot of debris,” he says. “I go out several times a week and pick up garbage and put it all in the dumpster.”
Another Arlington Street resident, who asked that his name not be used in this article, says that “the flow of people from BBH on our street—urinating in the alleys, trash, fights, things like that,” has slowed. “They actually had a good response,” he says of the company.
But many perceive the high volume of drug treatment and transitional housing in the neighborhood to be less than ideal. “Rehab is great, but too much in any one neighborhood can be problematic,” Hirsch says. “In some ways BBH can outnumber us.”
“There’s no reason to stop being a junkie in Pigtown,” says Sebastian Sassi,a Pigtown resident and anti-crime activist. “They’re made extremely comfortable” with a selection of drug dealers and drug treatment centers to cycle between.
“You’re basically just plunking down a lot of drug addicts in a place that’s already rife with illegal drugs,” says Michael Brown,another Hollins Roundhouse resident.
On a bright summer August midday, several older men walking toward BBH tell a curious reporter they know nothing about any recovery housing or drug treatments. A man calling himself “Downtown Shorty” points to a block of homes along Pratt Street, falsely declares them all to be recovery houses, and requests money.
A couple argues on the sidewalk in front of BBH loudly enough to be heard across Pratt Street. “ . . . and you were nowhere near BBH!” she says.
“I wasn’t,” he answers. “I wasn’t in the fuckin’ party!”
A block north on Lombard, a woman has set up a sno-ball stand in front of her house. “A lot of these guys are only in [recovery] for the housing,” she opines.
Two men walk past. The smaller guy, white and shirtless, theatrically squirms and exclaims, “Damn—I left my morphine bottle on the table.” He stomps away cursing.
The Rev. Vaile Leonard draws a bright line between true supportive housing and the pretenders. Leonard is the president of the Baltimore Area Association for Supportive Housing (BAASH), a five-year-old nonprofit organization that offers classes and coaching to those who want to open supportive housing for recovering addicts, and uses peer pressure to encourage voluntary compliance with laws, regulations, and best practices. The group’s 25 “chartered members” have 419 beds—between 1 and 2 percent of the number needed.
Expansion of the group has been fitful; the organization’s web site was recently suspended for nonpayment, according to a message there.But Leonard says 40 to 50 people came to the group’s September meeting at Coppin State University, and she hopes to accelerate the growth.
Among the biggest challenges Leonard says she faces is the ignorance of neighborhood leaders who assume all supportive housing is of the “so-called” variety. “So you have this split between people who are clamoring for services and the general public, who are just uninformed and have so much fear,” she says. “Most neighborhood associations fight to block recovery housing in their neighborhood.”
Another challenge: the City Council’s refusal to pass an ordinance, drafted in 2007, to normalize the siting of group homes.In 2009 the Baltimore City Substance Abuse Directorate, a consortium of several of the city’s large drug treatment providers, filed a lawsuit in federal court claiming that the city discriminates against disabled people by requiring drug treatment facilities to get permission from neighborhood associations before opening or expanding their facilities. Although supportive group homes are not healthcare providers and aren’t licensed by any government, the scrupulous ones do sometimes fall under the “group home” definition of the city’s laws. The proposed ordinance would change the way the city treats them, and bring the city into compliance with federal housing law and the Americans with Disabilities Act. (Currently, the city government usually defers to neighborhood associations, meaning that a group home operator has to obtain permission from a neighborhood association before opening a home or expanding it.)
The lawsuit, filed by Ellen Weber of the Maryland Disability Law Center, charges city leaders with “intentional discrimination” and demands punitive damages under the Fair Housing Act. Weber, who sits on BAASH’s advisory council, declined to comment, citing the pending litigation.
Leonard lets a volunteer house manager (she asked that her name be withheld for privacy) lead a tour of her house on Payson Street, about a block below North Avenue. Although fully equipped with fire extinguishers, smoke alarms, and a bright red exit sign over the front door, it’s otherwise a typical rowhouse with three bedrooms and a bathroom upstairs and a kitchen, dining room, living room, and porch on the first floor. The basement is paneled and contains several donated computers—soon to be hooked up, the house manager says—plus a laundry room with a half bath, an area for Narcotics Anonymous meetings, and a urine test kit. Residents are tested randomly, the manager, who doubles as the house cook, says. In four months she’s not seen a dirty urine sample, but if one shows up, “my understanding is you get that person directly to detox.”
The program fee (Leonard says she doesn’t collect rent) is $300 per month. That includes food, clothing, rent, and utilities. Three women live here now (plus the house manager), but each bedroom has two beds, so it can accommodate up to five clients. “We try to keep our houses small,” Leonard says. “So they’re more like a family.”
The house manager says the house is often at less than full capacity, as some clients discover the regimented lifestyle of recovery is not yet for them. “A lot of addicts look to supportive housing as a minus instead of a plus,” the manager says.
The finances of the house make sense, in part, because there is no mortgage. Leonard inherited the building from an uncle she took care of for years, she says. BAASH offers financial training to prospective members, but many of the people who come to meetings already have houses.
“The biggest misconception people have is that this is a money maker,” Leonard says. “Like any other business, you have to work, and build the business before it will make a profit.” In 11 years, the nonprofit Light of Truth Center she founded to operate her two houses has not made enough to afford her a salary. “Everything here is donated,” she says proudly, nodding to the big-screen television and bags of clothing bundled in the living room.
Leonard’s dream is to ramp up BAASH to transform the way supportive housing is done in Baltimore. “Think of the gap in services,” she says. “We could grow a corps of people who could, professionally, fill that gap. We have an opportunity to change the face of Baltimore.”
She hopes an expanding BAASH will help educate neighborhood leaders not to oppose well-run supportive homes, and she hopes that the city will partner with the group to create a legal structure for the houses—to drive out the bad, educate and improve the marginal, and support and expand the good. “Why couldn’t the city say, ‘If you’re going to open a recovery house or a sober house you have to at least go through the [BAASH] program?’” she asks. Despite having worked with state officials to develop a working definition of state-funded supportive housing, BAASH has heard nothing from city housing officials since a task force on the subject ended five years ago, according to Leonard. “We’ve not been invited to the table,” she says. “We’re still so small, most people don’t know we’re here.”
Willie Broadnax moved to Baltimore from North Carolina with his family when he was five months old. The former “hospital police” is 56 now, with a $1,700 monthly pension and some disability for major arthritis in the knees, which are scarred on both sides. He uses a cane to descend the steps of his temporary home at 1326 Hollins St. before climbing into his full-sized Nissan pickup truck. He has been through rehab before, he says. And he worked all his life—at the hospital, and moonlighting as a Rite Aid security guard every other weekend, a 12-hour shift.
Soft spoken and patient, he’s the social opposite of his housemate, Troy Blackburn, with whom he has lived for two weeks. “It’s what you put into it,” he says of his living situation.
Broadnax doesn’t plan to stay here long. He applied for housing with HUD, but even after he moves from the Hollins Street house, he’s staying in the program, he says.
Stevie Wonder and Luther Vandross croon on the truck’s stereo as Broadnax drives the four blocks to BBH’s Housing Resource Center to pick up a prescription. The air conditioning blows cool.
Broadnax says he has been in some recovery houses that cost him $400 a month. Right now he’s on the waiting list for low-income, disabled housing. The folks behind the housing counter were vague about how long he might actually need to wait, he says. It could be six months. He’s got his eye on a place downtown, “near the Inner Harbor,” he says. He is asked where he’d park if he lived there. “Oh, there’s a garage,” Broadnax says, climbing out the door of his big truck. He leaves it running while he limps toward BBH to get his meds.