There’s wide consensus among mental health advocates and government leaders that board-and-care homes are a crucial housing option for people living with serious mental illness.
Los Angeles County Supervisor Janice Hahn has called them “vital” and said they are often “the only thing standing between their residents and homelessness.”
So what do we know about these types of facilities? And how can Angelenos find ones that suit their needs?
The background on board and care
Adult residential facilities — commonly referred to as board-and-care homes — offer housing, daily meals and medication management for thousands of Angelenos living with mental illness. A study published last year that surveyed more than 600 board-and-care residents in L.A. County found that about half had experienced homelessness as an adult.
But many operators say they’re being pushed out of the business because of a lack of supplemental and reimbursement funding from the state and federal government.
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“There really needs to be more effort at the state level to direct funding to the smaller facilities — even the six-bed and fewer facilities — because they’re an integral part of our continuums of care,” Aimery Thomas, managing director of the consultant group The Future Organization, said in an interview with LAist.
Some operators say they hoped to receive funds through Proposition 1, which was passed by California voters in March, but now they fear they may be overlooked.
How many are in L.A. County?
There are some 3,065 adult residential facilities and residential care facilities for the elderly in Los Angeles County, according to The Future Organization study. But not all serve the most vulnerable populations, like people who get by on supplemental disability benefits. Like every business, the facilities vary in quality.
About 750 of those facilities specifically serve people living with mental illness – people who have been unhoused and who rely on public benefits for their housing and care.
The size of those facilities can vary widely, ranging from only a few beds to dozens. In total they have an estimated capacity of 25,000 beds, according to the study.
What is the cost to taxpayers?
According to The Future Organization study released in August 2023, the mean cost per resident, per year at L.A. County board-and-care facilities that receive public funding was $20,713.
That’s compared to an estimated $34,194 in public services to care for people living on the streets.
How do I find a board-and-care home?
Here are a few resources that could help:
- The Licensed Adult Residential Care Association has a vendor map where you can find a facility.
- Los Angeles County has a directory where you can search licensed facilities by name and service area.
- The National Alliance on Mental Illness – Westside Los Angeles put together a listing of L.A. County Board-and-Care liaisons who can provide assistance.
How many have closed?
Since 2016, more than 2,000 board-and-care beds in L.A. County have shut down, according to a recent report from the county Department of Mental Health.
At least 155 adult residential facilities have closed during that time. Last year alone, facility closures led to the loss of about 150 board-and-care beds in the county. Operators have long cited rising costs and low reimbursement rates from the state and federal government as reasons for the closures.
What do residents say about them?
The Future Organization conducted 625 in-person interviews with residents in 2022. It found residents reported “very high mean levels of overall satisfaction,” with an average score of 8.5 out of 10.
About 1 in 2 residents surveyed said they would probably be unhoused if it was not for their board-and-care housing. And nearly 90% said they felt like they were part of a community at their board-and-care.
