Coco Cox left an adult home and is now living on her own in the Bronx — alongside her four cats. Photo: Curtis Skinner

New York State is taking measures to relocate thousands of New Yorkers with severe mental illness out of adult homes and into community living, in a shift that will affect dozens of facilities and could force some to shut down.

Regulations issued by the state Department of Health this month require so-called  transitional adult homes — large-scale group living facilities of more than 80 beds — to lower the number of mentally ill people they serve to less than a one-fourth of the home’s total population. Any homes with more than that share will be prohibited from admitting new mentally ill residents and can be fined up to $1,000 a day until they lower their numbers.

The measure comes after years of litigation by advocates for the disabled, who had sued the state a decade ago alleging that mentally ill adult home residents suffered unsafe and unsanitary conditions. The state won on appeal in 2012, but also pressed ahead with the changes to avoid further combat in court. In August, the Office of Mental Health’s Chief Medical Officer, Lloyd I. Sederer, declared adult homes with high concentrations of mentally ill people “not clinically appropriate” and “not conducive to their rehabilitation or recovery.”

“This is a very important and timely civil rights issue. These regulations have the potential to end many decades of discrimination,” said Shelly Weizman, senior staff attorney at MFY Legal Services, a residents’ rights litigator based in the city and one of the key firms representing plaintiffs in the lawsuit, Disability Advocates v. Pataki.

The state Department of Health and the Office of Mental Health did not respond to repeated phone calls and emails seeking comment and clarification for this story.

Adult homes are non-medical residential facilities that house people with disabilities and mental illness. After psychiatric hospitals across the state shuttered through the 1970s and ’80s, adult homes increasingly began to take in the mentally ill.

In the city, about 4,000 mentally ill people currently reside in these large-scale adult homes, according to an MFY analysis of 2011 Department of Health data. That year, a total of 8,469 New York City residents lived in adult homes.

The new state rules will be transformative, according to adult home administrators.

“These regulations will basically have the effect of shutting down our facilities,” said Jeff Edelman, board member of the New York State Center for Assisted Living, an industry trade group, and operator of three adult homes in the city.

Two of his centers — Parkview Home for Adults, in the Bronx, and Wavecrest Home for Adults in Far Rockaway, Queens — serve the mentally ill almost exclusively. Edelman contends that not only would the industry be harmed, but so would the majority of residents, who have built community at the homes and he says aren’t capable of surviving independently.

“These are residents that do need supervision and services that we provide in the facilities,” he said, “and these are residents that are indigent and on SSI and have nowhere else to live.”

To add insult to injury, said Edelman, the rules require that the homes write up transition plans for the residents themselves.

“They’re basically asking you to write your own obituary,” he said.

The state Department of Health has acknowledged industry concerns. “It may be the case that some adult homes will no longer be able to stay in business in their current form,” the agency wrote in response to public comment. “However, the Department’s primary responsibility is to the health, safety and well-being of adult home residents.”

For years the city’s adult home industry has been rife with problems. A 2002 exposé by Clifford J. Levy in The New York Times uncovered serious, and sometimes fatal, deficiencies in care and oversight at the city’s homes, and came shortly before disability rights advocates filed suit against the state.

While some homes have improved since then, advocates say they still receive a high volume of complaints about staff supervision of mentally ill residents.

One Brooklyn adult home resident welcomed word of the state’s actions. “This is revolutionary in a sense,” said Norman Bloomfield, 65, a resident of Surf Manor Home for Adults in Coney Island. He has been living at the home for 11 years. While he declined to share his own plans, said he’s seen his share of residents who wanted to leave the home and the regimented lifestyle it requires but couldn’t find other places to live where they would get support in the transition to living independently.

“I think it’s exciting for many people who’ve been in here for so long…when you’re here, you’re stuck in limbo,” he said, “This is their chance, you know?”

Coco Cox, 69, has already made the move out, and says she finally feels free of the “army” lifestyle she led in her adult home. For most of her life, Cox had been a working woman. It wasn’t until the sudden passing of her husband that a bout of depression landed her in Riverdale Manor, in the Bronx.

About six years ago, she learned of the Coalition of Institutionalized Aged and Disabled and the group helped her relocate into her own studio apartment. Cox remains an active member of the group and says the freedom she feels living independently has been liberating.

“When I was living in an adult home, I wasn’t able to live the life I lead now,” she said. She noted, for instance, that the food at Riverdale was “horrendous” and the ability to cook her own food, which may seem small, makes all the difference. Her apartment, decorated with homey touches like a crocheted afghan, is also home to four cats.

“It’s so much better to be able to do things like that, than live in this regimented lifestyle where you don’t live, you just exist.”

The Office of Mental health put out a call to contractors last summer to develop and operate 1,050 apartments in Brooklyn and Queens to aid the transition, with mental health and other services readily available to residents. 

But whether the state will be able to provide sufficient housing for mentally ill residents now in adult homes remains unclear.

“Even the most well-intentioned adult home would still have to find apartments for people to live,” said Jota Borgmann, senior staff attorney at MFY. “Last time we looked, there were about 4,000 adult home residents with mental illness in transitional adult homes in New York City. So even if 25 percent could and wanted to stay in the adult home, there would need to be housing options for the other 75 percent.”