Cothran

And if the commission votes against expanding the guest home, its members will suffer a shit-storm of liberal whining.

My advice to the commission: Don't listen to the mental health advocates, none of whom lives in the neighborhood, too few of whom have ever visited the home -- and all of whom have a direct professional or financial self-interest in seeing the home expand.

Put on your rain slickers and vote no. It's the right thing to do. Here's why.

I have talked to Nelvin Jr. and Charlotte Johnson at length about the planned expansion of their facility. They seem like nice people who have a fairly decent grasp of their business and their residents' needs. Since I have only met them once, I will assume the best about them. And I do not believe the residents of the guest home are hor-ribly mistreated.

Still, after interviewing neighbors, reading their letters, listening to their testimony, and reviewing public records, I can't escape the notion that, at best, the Johnsons are maxed out. Even at the current level of 18 residents, their home has made serious slips in regard to the care and control of clients.

But more troubling than the lapses in care is the Johnsons' rather global dismissal of the neighbors' concerns. When I asked Nelvin Jr. why 23 of his immediate neighbors all echoed the same concerns and complaints -- residents routinely smoking and drinking on doorsteps; residents who left behind garbage, including broken glass; residents who became aggressive -- his response was, "I think it's far easier to manufacture dissent than consensus."

He denies any of his residents use illegal drugs or alcohol. "It's untrue and there is no public record of it." He says the neighbors confuse vagrants with his residents.

Fine. I'll give the Johnsons that neat bit of plausible deniability. But I can't ignore what the neighbors have observed.

About six months ago, one neighbor, Ann Kirschner, began finding a man who lived at the guest home on her front steps, drinking heavily and smoking.

We'll call the man Hank.
Hank is a severe alcoholic with a serious mental illness. He'd lived at the home for eight years. Each time Kirschner asked Hank to move, he refused. Whenever he did move on, a pile of trash remained. Eventually, he began to grow agitated when she asked him to leave. Agitated and, over time, aggressive. Kirschner went to Nelvin Johnson Sr. on three separate occasions. Each time, Kirschner says, the elder Johnson told her he could do nothing; she should call the police.

But Ann didn't want to call the police. To her mind, drawing down the weight of law enforcement on a mentally ill alcoholic was out of the question. It was mean.

Finally, during one encounter, Hank shoved her, bumped her, and spat at her. This was about the time the Johnsons put up a notice on their building, telling their neighbors they were planning on expanding.

Kirschner couldn't believe it. They couldn't properly deal with Hank -- and they wanted more Hanks?

She called in state officials to investigate the situation. They agreed the guest home was negligent and issued a citation. Hank was moved to another facility that could better deal with his substance abuse issue. (The Johnsons say eviction procedures against Hank were under way before Kirschner complained to the state.)

What's important to focus on here is that it was through Kirschner's intervention, the action of a so-called NIMBY bigot, that Hank got the help he needed.

Around the same time that Hank was causing problems, neighbors also complained to Social Services officials about a man with feces and lice on his person. As it turned out, according to the state report, the man was incontinent and refused to attend to his hygiene. The report states that the Johnson Guest Home could not, and did not, attend to the man's needs. He required a higher level of care at a skilled nursing facility, one doctor said.

Again, a callous NIMBY neighbor intervened and made sure the state provided the proper level of care.

I can supplement the neighbors' hygiene concerns with my own experience.
Earlier this month, I was headed for interviews for this column when I passed by the guest home. On the steps sat two men. One was wearing pants that looked as if they had not been washed in a week or more. The other man's socks were black with grime.

How much you can extrapolate from these incidents is hard to say. Are they the norm or are they anomalies? No one knows, least of all the state office charged with monitoring long-term care facilities like the Johnson Guest Home.

The state Department of Social Services' Community Care Licensing Bureau normally employs four caseworkers to oversee the approximately 400 care homes in San Francisco. But for the past several months, S.F. has only had two investigators assigned to the city. The Johnson home is one of the facilities without a state worker assigned to monitor it. (I was promised, however, that the home gets visited at least once a year. Which completely eased my mind.)

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