Problems and needs of operators of board-and-care homes: a survey

The closing of 42 board-and-care homes in San Francisco since 1977 has contributed to a critical shortage in the city's community housing for the mentally ill. A task force convened in 1985 to research the causes of the growing housing crisis and seek solutions to it surveyed the operators of the city's 74 remaining board-and-care homes to determine their problems and needs. Based on the operators' responses, the task force identified five main reasons for the declining availability of board-and-care beds for the mentally ill: operators' failure to make a profit, advancing age among operators, high mortgages that discourage people from opening the homes, state payment schedules that lead operators to take in developmentally disabled clients, and increasing numbers of young, difficult clients. The task force and the authors recommend several approaches to resolving these problems.