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Nov. 25, 2011

Questioning Yaffa priorities

Homes expand in number but concerns have been raised.
BASYA LAYE AND CYNTHIA RAMSAY

In 2000, the doors of the first Yaffa House were officially opened. In 2010, right next door to its predecessor on East 58th Avenue, Yaffa House II opened. On Dec. 1, a partner facility in the Dunbar area will allow for five additional dedicated spaces for Yaffa House residents.

Vancouver Yaffa Housing Society (VYHS) was started in 1993 “for the specific purpose of creating housing facilities having Jewish cultural and ethnic atmosphere and offering opportunities for those with mental disabilities to participate within the Jewish community.”

Yaffa House 2000, a commemorative booklet with the subtitle, “A Group Home for Young Jewish Adults with Special Needs,” was published by VYHS in 2000. In addition to stating the purpose of VYHS, it also notes, “The intention of the

Yaffa Housing Society is to create a warm and nurturing environment, which will foster the health and inclusion of our people.” The belief statement in the same document includes a stress on fostering the “individual potential” and “independence” of its residents, “taking into consideration the different personal, changing and dynamic needs of each resident.”

At press time, Yaffa I had four residents and Yaffa II had two. According to at least one resident, the goal of providing both independence and a warm, nurturing and healthy environment has proven challenging.

Jori Fisher has been living at Yaffa House for almost a decade, after a short stint in Israel and 10 years in Toronto. High functioning and employed outside the house, Fisher has Tourette Syndrome Plus, a neurologically based spectrum disorder.

In a letter to the Jewish Independent, Fisher expressed his frustration with what he sees as the challenges, highlighting what he calls “the deplorable situations which exist at Yaffa,” specifically to do with “the conditions regarding security, safety and sanitation.” He wrote, “It appears to me that a reality check is definitely in order and, perhaps, our community needs to come to terms with the ‘shanda [shame] factor’ regarding those with special requirements.”

Fisher told the Independent that he participated in a Jewish Federation of Greater Vancouver task force meeting on disabilities in the early 1990s, “suggesting that it was time for the Jewish community to consider housing for those in need who were not yet of an age to consider the Louis Brier Home [and Hospital]. The very first meeting towards this goal took place in my parents’ home.”

According to Fisher, “That which was anticipated at that time is a very far cry from that which exists today! When I return from my work ... the other residents have retired for the evening, and I find it mandatory for me to check the home to make certain everything is as it should be.” He added that he was promised some form of recognition for performing this and other tasks, but that it never materialized.

“My mother has been my strongest advocate on these and many other matters at Yaffa House,” Fisher wrote, commenting later that, “The response she is given to her questions regarding policy and procedure at Yaffa House is usually met with absolutely nil … or that Yaffa House is in the category of an unlicensed home. Obviously, neither of these responses is adequate.” While noting that “Jewish group homes for those in need are required, and their establishment should be viewed as a great mitzvah,” Fisher stressed, “I feel I must air these serious issues to, and in, my own community.”  

Fred Dexall has lived at Yaffa House I for 10 years. During a visit to the residence by the Independent this summer, he shared that he was the first person to move into the house and that he was involved in the proposal for its creation. Over the years, Dexall said he has witnessed many changes and some issues have arisen.

“We’ve had a few things fixed up,” he said. “I’ve noticed that people come and go, some acted up or had emotional problems, but this is a quiet house and it’s a nice neighborhood; I know where I’m going,” he said.

Whereas Fisher plans to leave the house, Dexall plans to continue living at Yaffa for the foreseeable future. “I’ve lived at other places, but I think I’m just too tough to re-situate. It takes a whole year for a handicapped person to settle down in a house and I feel, personally, that this is a good place. I helped start it and I’m not moving away.”

In advocating for her son’s welfare, Fisher’s mother, Ava Lee Millman Fisher, has routinely challenged VYHS to address her concerns around the health and safety of residents in general. She has complained of unsanitary conditions in the home – she claims she has found blood on household objects and food – and safety – she says that oven burners have been left on, exterior doors left unlocked and there has been inappropriate behavior by residents, for example.

“I have most definitely been to the home on numerous occasions, and have seen great cause for concern,” she told the Independent in an e-mail interview. “The home(s) certainly do not represent that which we envisioned when we undertook to see this project through to fruition. I have retained the original booklet of rules, regulations and guidelines, which was published by Yaffa 10 years ago. There are severe problems! Firstly, there is a lot of information within the written material which is not congruent; secondly, so much of this is most definitely not adhered to; and thirdly, I doubt that there has been any official rewrite of this material within the last 10 years. Basically, the residents are both a danger to themselves and to others.”

“Coast Mental Health Foundation is the primary body responsible for the running of Yaffa House care and programming,” explained VYHS president Avie Estrin to the Independent in an e-mail. “JFGV [Jewish Federation of Greater Vancouver] is involved with VYHS as the conduit for much of the funding provided Yaffa ... but has also provided additional support in the way of programming funds, most recently via the Community Inclusion Grant, which is again implemented by Coast Foundation. JFSA [Jewish Family Service Agency] has to date cooperated with Yaffa in the capacity of one of the client referral sources for our homes.”

About Millman Fisher’s concerns, Estrin said, “Due to the complaints generated by Ava Lee Millman [Fisher], Yaffa House has had no less than four health inspections by the Environmental Health Office [EHO] (most recently on Nov. 15, 2010), each one reporting zero evidence of health concerns whatsoever. Moreover, at the persistence of said complainant, Yaffa House was additionally visited by the director of the Patient Care Quality Office and the manager of Mental Health and Addiction Housing (Coast), who together reported that: ‘As Alyson, the EHO, or I were unable to observe the concern and the other residents and Coast staff have not brought forward similar concerns, [it] is difficult to validate this complaint.’”

Renay Bajkay, director of residential services at Coast Mental Health, clarified the relationship between YHS and CMH. “CMH views our primary role as one which focuses on the human resources aspect of the Coast employee working at Yaffa, providing support to the clients at Yaffa House and some of the programming,” Bajkay told the Independent in an e-mail interview.

According to the 2011 VYHS President’s Report, released on June 26, 2011, Coast’s most significant contributions to Yaffa’s programming include one Coast-funded cleaning day per month at Yaffa I, in addition to the four cleaning days VYHS is already providing; on-call access to a mini bus and a driver for organized house excursions; an activities therapist to take residents out twice a month on varied excursions; the facilitation of a peer support worker, provided through a Federation-funded Community Inclusion Grant and implemented by Coast, four times a month; 24/7 on-call support for residents in case of emergency; and various ongoing in-house workshops for residents.

For an unlicensed facility like the Yaffa Houses, Bajkay assured the Independent that, “Coast implements at all sites our quality-improvement systems, including a reporting incident and accident system. All staff is trained to use this system. Coast Mental Health monitors the quality of the programming using a measurable system and this system is used in licensed and unlicensed sites. Concerns brought directly to our attention would be addressed with the individuals involved.”

According to Bajkay, “It is our experience that, in group home settings, it is often the case that situations of conflict arise.”

About this, Estrin said, “Residents have direct access to the Coast mental health care worker on site or to any of the Yaffa board volunteers, who collectively visit the home at least once a day, virtually every day of the week.”

“We get help from the [VYHS] board and from Charles [Leibovitch], who’s our worker,” said Dexall about how problems are handled at the house when they arise. At another point in his interview with the Independent, he said that many of the residents attend Yaffa’s annual board meetings. “We have a voice,” Dexall stressed.

Leibovitch, a certified mental health care worker, is contracted by Coast 25.5 hours/week, as the onsite worker at Yaffa, said Estrin. He added that Alex Krasniak, Dexall’s personal aide and companion, is also on site for a split shift every day, seven days a week, and that all of the residents have been advised and instructed about Coast’s 24/7 on-call emergency support, the numbers for which are posted in the house.

“When I’m looking after Fred,” Krasniak told the Independent when the paper visited Yaffa I in August, “I’m also looking after some of the other guys in the house, and I’ve got 20 years of experience in it.”

He said, “This house is almost perfect in every standard. When I say ‘almost,’ the emphasis is on almost; there is no such thing as perfection.”

He confirmed Dexall’s observation, saying, “There was some movement of clients here, in a general atmosphere which is, in many ways, better, and, in many ways, not. The only thing I want to add regarding the changes is that this is a special design for special needs people; people are different. They happen to be, in this environment, high functioning, which makes looking after their needs even more difficult and, basically, you cannot satisfy everyone and maybe not everyone even fits this program. But, being a Jewish home, being what we are, we are not in a hurry to make drastic changes and to [potentially] hurt many people.”

Krasniak described the atmosphere of the home as “mostly very casual” and said that, whenever disputes arise, they get solved quickly.

Both Krasniak and Dexall said that Leibovitch was in charge of the house.

“Charles is sort of in charge,” said Krasniak. “Now, he comes from Coast and is doing the best to run this house, except they pile on him sometimes too much administration, so he has too little time for hands-on, in my opinion, and that’s a pity because I saw him in two programs – Bagel Club and L’Chaim, for the elderly – and I saw he is terrific with hands-on, if you give him a chance. Now, we have some more volunteers who come into the house.... Charles, through his administration, constantly organizes young people, volunteers, to come over and spend time with groups of clients or with individual clients – volunteers make their own choice [as to] whomever they hook up better with.

“It’s not neglected. We are taken care of and, bottom line, there is also a fine line between running the house well, running it correctly, and affecting people’s independence, freedom and space. We know it’s very easy ... to build a schedule in which people will be busy for most of the day; a question is if they want to be busy most of the day? So, there’s a balance line here, and some things are not done immediately on the spot. Sometimes, when flowers need attendance, need some water, they might stay without water for a day because people don’t feel right now like leaving their TV program ... and going out and to water the flowers because we tell them,” explained Krasniak about why some residents may feel that their complaints are not being heard. “This is a difficulty of running a program with high-functioning people: they have choices.”

In Millman Fisher’s view, the problems are systemic. Millman Fisher noted that the 2000 document uses the terms “mental disabilities,” “mental illness” and “special needs” interchangeably and, in addition to pointing out that the original vision was for “young Jewish adults” – her son, at 39, is the youngest resident at Yaffa, she said – she also doesn’t believe that the current residents meet all of the admission criteria, including an ability and willingness to adhere to a kosher diet and the basic skills for self-care.

She told the Independent, “There are many obvious changes that need to occur to turn this organization into an appropriately functioning one. Firstly, it must become transparent and accountable. Financial records must be up to date and accurate. Policies and procedures should be updated, documented in writing and adhered to. There must be consequences for the residents when boundaries are crossed.... To match the level of functioning of most of the residents, there must be more staff put into place; or, there needs to be a change in residents to those who are able to manage with so little supervision.”

She added, “Yaffa has a nice piano, flowers in the garden, etc. However, the residents are living in humiliating and constantly degrading conditions. As one of my sons, a highly devoted special needs secondary school teacher, is constantly instilling in his students, ‘necessities before accessories!’”

In Krasniak’s opinion, “It’s not perfect, as I said. It’s not sparkling clean all the time. People leave crumbs on the table. When Fred makes coffee, occasionally he [makes a mess with] this coffee because he can’t see. Other people leave some mess behind because of their own limitations; they are not perfect. We are trying our best.

“We have this separation, having a Jewish home, we have a separation of dairy and meat,” Krasniak continued. “This separation is not perfect. Sometimes, we goof. We are not making a big deal out of it. We are trying our best.”

As the Dunbar units are set to open next week, a question Fisher raised in his letter to the Independent about Yaffa II remains: “And, now that Yaffa has two homes,” he wrote, “I cannot help but wonder why the homes together have but one more resident than the first home had alone ... especially, in view of the fact that there is such a great need for housing.”

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