Law 19 - Property
Law - Mock Trial
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NAAH, Neighbors Against AIDS Homes, Marsha(ll) Gaskins,
et al., and those Similarly Situated
v.
Vic(kie) G. Knight as Trustee of the John King Trust and Administrator
of "Our House"
Statement of Facts
"Our House" was established by John King, whose will created the King Trust. The king trust provided that upon John King's death, his house located at 4210 Clover Street, N.W. in the District of Columbia, be used as a group home for persons with AIDS. The King Trust also set up a fund of $3.5 million for the care, upkeep and administration of the house and necessary support of its residents. Vic(kie) G. Knight is trustee and administrator of the trust. Six persons, including Knight, currently live in the residence known as "Our House." The first residents were accepted on March 15, 1989. All the residents except Knight have AIDS.
"Our House" is located in an area zoned as an R?1 residential district. In an R?1 district, single family dwellings are permitted, but health care facilities or community-based residential facilities are not permitted without a variance of the zoning code.
Local neighbors formed a coalition, "Neighbors Against AIDS Homes," known "NAAH." NAAH and its members are opposed to "Our House" in their neighborhood.
Claims and Defenses
The plaintiffs, NAAH and its members, have brought suit against the trust and Knight as trustee and administrator of the trust. The plaintiffs claim "Our House" is operating as either a health care facility or a community-based residential facility, or both, in violation of local zoning ordinances. In addition, the plaintiffs claim that "Our House" constitutes both a private and public nuisance. The plaintiffs deny any past or present discrimination against residents of "Our House."
The defendants claim that they are in compliance with the single-family residence requirement of the R?1-zoned area. They assert that "Our House" is not a health care facility or a community-based residential facility; rather, it constitutes a single- family dwelling permitted under the zoning ordinance. In addition, the defendants claim that their residence at 4210 Clover Street, N.W. does not constitute a public or a private nuisance.
The defendants charge that NAAH is discriminating against "Our House" and its residents because they have AIDS, in violation of the Federal Fair Housing Act of 1989, which bars such discrimination.
Relief Requested
The plaintiffs are seeking a permanent injunction barring "Our
House" from continuing to operate as a health care facility
or a community-based residential facility for persons with AIDS
at 4210 Clover Street, N.W. Furthermore, the plaintiffs request
that the injunction should prohibit the defendants from having
a group of persons with AIDS living at 4210 Clover Street, N.W.
The plaintiffs also request attorneys' fees and court costs.
The defendants ask that the injunction be denied and that the
trustee and residents of "Our House" be declared a "family"
according to District of Columbia zoning regulation 199. Alternatively,
if the court finds the defendants to be operating as a health
care facility or a community-based residential facility as defined
by District of Columbia regulations, the defendants ask the court
to stay the injunction, allowing them to apply for the necessary
license. The defendants also request attorneys' fees and court
costs.
Stipulations
Both parties agree to the following:
Witness statements are sworn and notarized. They may be used for impeachment, and may not be admitted into evidence.
Doctors Moss and Brown are qualified as experts with respect to AIDS.
The permit needed to make extensions to "Our House" was granted and is not at issue.
Witnesses
For the Plaintiffs For the Defendants
Marsha(ll) Gaskins Vic(kie) G. Knight, Trustee
NAAH coordinator and Administrator of
"Our House"
Dr. Mel(anie) Brown M.D., M.P.H Dr. Paul(a) Moss, M.D.
Epidemiologist, B-Well Faculty, Georgetown Univ.
Pharmaceuticals Medical Center, Department
of Infectious Diseases
Eva(n) Buttle
Former house cleaner, Terry Campbell, resident,
"Our House" "Our House"
APPLICABLE STATUTORY LAW
updated:
7/14/05
Prof. J.
1. Applicable District of Columbia Zoning Regulations*:
199 Definitions
Family: one (1) or more persons related by blood, marriage, or adoption, or not more than six (6) persons who are not so related, living together as a single housekeeping unit, using certain rooms and housekeeping facilities in common.
Dwelling: a residential building used or intended to be used for human habitation by members of not more than one family.
Community-based Residential Facility: a residential facility for persons who have a common need for treatment, rehabilitation, assistance, or supervision in their daily living. This means a facility that provides a safe, hygienic, sheltered living environment for individuals 18 or older who desire or need such an environment because of their physical, mental, familial, social, or other circumstances, and who are not in the custody of the Department of Corrections.
Health Care Facility: a residential facility providing medical or nonmedical services consistent with accepted professional, therapeutic medical care concepts and practices and with current health programs and legislation.
200 R-1 DISTRICTS: GENERAL PROVISIONS
200.1 The R?1 district is designed to protect quiet residential areas now developed with one-family detached dwellings and adjoining vacant areas likely to be developed for those purposes.
200.2 The provisions of this chapter are intended to stabilize the residential areas and to promote a suitable environment for family life. For that reason, only a few additional and compatible uses shall be permitted.
201.1 The following uses shall be permitted as a matter of right in R?1 residence districts:
(a) One-family detached dwelling;
(b) Church or other place of worship;
(c) Parsonage, vicarage, rectory, or Sunday school building;
(d) Public schools, subject to the provisions of chapter 21 of this title.
213.1 The following uses may be permitted with a variance in R?1 districts:
(a) One-family, semidetached dwelling; and
(b) Youth residential care home, community-based residential facility, or health care facility for five (5) to eight (8) persons, not including resident supervisors and their families.
2. D.C. Code §25-401 Public Nuisance:
§25-401(a) Housing with violations that constitute a danger to the health, welfare, or safety of the occupants is declared to be a public nuisance.
§25-402(b) It is the purpose of this section to declare expressly a public policy in favor of speedy abatement of the public nuisances referred to in §25-401, if necessary, by preliminary and permanent injunction issued by courts of competent jurisdiction.
§25-403(c) A zoning variance may be granted only where and to the extent necessary in the case of exceptional or undue hardship, and only when compensating factors are present that give adequate protection to the public health, welfare, safety, or morals, and the variance can be granted without impairing the intent and purposes of the housing program of the District of Columbia in this subtitle.
3. Federal Fair Housing Act, Amendments of 1989:
§3601. Mission: It is the intent of Congress through this Act, to secure an end to discrimination for any reason other than that of individual merit. Bias against those with physical handicaps is included among the forms of discrimination prohibited by this Act.
§3604. It is unlawful to discriminate in the sale or rental of, or to otherwise make unavailable or deny, a dwelling to any buyer or renter based on handicap of:
(a) a person residing in or intending to reside in that dwelling after it is or sold or rented or made available;
(b) any person associated with that buyer or renter.
§3610. A physical handicap is a bodily or mental disablement which may be the result of any injury, illness or congenital condition for which reasonable accommodation can be made. Within this definition, a person who suffers a "bodily or mental disablement" due to an "illness" related to AIDS disease is handicapped under the Act.
§3617. It is unlawful to interfere with the exercise or enjoyment of a right protected under §3604. This section may be enforced by appropriate civil action.
APPLICABLE CASE LAW
Foont v. Berland, 203 N.E.2d 1249 (1986)
A private nuisance is an unreasonable interference with the
use and enjoyment of land. The defendant's conduct must be weighed
against the amount of harm to the plaintiff. The question is not
simply whether a person is annoyed or disturbed, but whether the
annoyance or disturbance arises from an unreasonable use of the
land. Factors include visual changes and obstructions to land,
noise, and disruption of quiet enjoyment, including sleep.
Whether a given use complies with controlling governmental regulations
is a measure of reasonableness. The fact that a use does not comply
with legal restrictions does not automatically make it a nuisance.
But failure to conform to the regulations may show that a use
is unreasonable.
Spring View Neighborhood Association v. Well Fed Community Center, 31 Fed. 2d. 586 (1985).
A public nuisance is an unreasonable interference with a right common to the general public. Such unreasonable interference may include the following:
(a) conduct involving a significant interference with the public
health, safety, peace, the public comfort, or convenience, or
(b) conduct forbidden by a statute, ordinance, or administrative
regulation.
The neighborhood association brought an action for temporary
and permanent injunctions to enjoin the community center from
providing free meals to indigent persons. The plaintiff was entitled
to a temporary injunction. The plaintiff showed that the center's
clients frequently trespassed, urinated, consumed alcoholic beverages,
and littered on residents' property. The neighborhood center affected
the neighbors' use and enjoyment of their real property. The permanent
injunction was denied, however, to give the community center a
chance to remedy the harm.
City of Storrs v. Transitional Center, 191 A.D.2d 1012 (1988)
To secure an injunction against a zoning ordinance violation or a public or private nuisance, a plaintiff may be any person whose rights to enjoy property have been infringed. An injunction is a court order restraining someone from doing, continuing to do, or threatening to do a certain act. To secure permanent injunctive relief, a plaintiff must present evidence demonstrating irreparable harm. The burden is upon the plaintiff to prove actual or threatened irreparable injury.
Williams v. Schaeffer, 108 Arizona Supr. Ct. 745 (1987)
Neighbors sought to enjoin the operation of a group home for mentally handicapped persons and one housekeeper as a violation of single-family dwelling restrictions of city zoning ordinances identical to those of the District of Columbia. Neighbors objected to alterations made to the house and complained of increased noise in the area, claiming these constituted a nuisance. Neighbors also claimed that the house would adversely affect the property values of their homes. Alterations to the house included the addition of three closets, a full bathroom, a second rear door, and a fire ladder at the rear of the house.
The court concluded that nothing in the record indicated how these alterations made this house any different from one used by the typical American suburban family. None of the alterations made in the house operated to change the character of the structure as a single-family dwelling. The five women functioned as a single housekeeping unit by sharing in the preparation of meals, performing housekeeping duties, and planning recreational activities. The housekeeper provided supervision and guidance similar to that provided by the head of any household. The day-to-day activities occurring at the home, as viewed from the outside, did not make it appear unlike the rest of the neighborhood. No injunction was granted.
Barker v. Sioux City, 63 Iowa Rpt. 2d 1142 (1989)
A private citizen sought to open a group home for homeless
persons infected with the HIV virus. The city sought an injunction
to prevent Barker from opening the group home on the grounds that
it posed a threat to the health and safety of the community, especially
due to its close proximity to a junior high school and park. The
city asserted that it acted pursuant to a legitimate interest
in zoning, particularly in regard to land use and public health
and safety. The court found that the plaintiff's irrational fear
of AIDS was a motivating factor in its refusal to grant Barker's
special use permit, which constituted illegal discrimination against
the handicapped. The city's restrictions were both intentional
and specifically designed to prevent persons infected with the
HIV virus from residing at the house. The injunction was denied.
Witness Statement of NAAH Representative
Marsha(ll) Gaskins
My name is Marsha(ll) Gaskins. I live at 4211 Clover Street,
N.W., Washington, D.C. I have lived at this address for six years.
I am married and have two small children. I live in a quiet, single-family
residential neighborhood. Many trees line the street. I bought
the house because there were many families with children living
on the street.
I am the coordinator of my neighborhood coalition, called NAAH,
which stands for Neighbors Against AIDS Homes. This coalition
was formed when I and eleven other families on the block heard
that John King's house was going to be used as a group home for
people with AIDS. It's not that I have anything against people
with AIDS. I believe that the people living at 4210 Clover Street,
N.W. are operating a health care facility or a community-based
residential facility for people with AIDS. These types of facilities
do not belong in a single-family residential neighborhood. The
house constitutes both a public and a private nuisance and is
in violation of the zoning ordinances.
I live across the street from "Our House." I can see
a lot of things that go on over there. First of all, a lot of
renovations were made to the house. Most of the renovations appeared
to have something to do with handicapped or bedridden persons.
For example, they put a ramp in front of the house and widened
the entrances. I saw appliances like refrigerators and sinks and
such being delivered, but none being removed. I think there is
more than one kitchen in that house. They added an additional
ground floor entrance on the side of the house and one on the
second floor.
One afternoon while I was washing my car in my driveway, I saw
one of the residents of the house come outside by her/himself
and start to walk up the block. I remember thinking to myself,
"S/He looks weak and is real skinny." S/He moved very
slowly, with hesitation. S/He walked a short distance towards
the end of the block when s/he staggered and fell face down on
the sidewalk. A woman driving a car stopped. She got out of her
car and ran over to the resident. By this time, a few neighbors
and I had gone across the street to see what was going on. The
woman ran back to her car and got some paper towels and put them
under the resident's bleeding mouth. The woman had a car phone
and called an ambulance. The towels were quickly saturated with
blood. She picked up the blood-soaked towels. I yelled to her
not to touch them, because the resident had AIDS. The group of
us from the block knew better than to get near this person's blood.
At this point the ambulance arrived and took the resident to the
hospital.
AIDS patients shouldn't be allowed in a residential neighborhood
where they can infect people with this deadly disease. A health
care facility shouldn't be allowed in a single-family residential
neighborhood because accidents like this, or worse, could happen.
The person shouldn't have been allowed out of the house on her/his
own. S/He was way too weak. S/He needed supervision. Here was
some unknowing person who came to the aid of a person bleeding
on the sidewalk. I can't help thinking that she'll probably get
AIDS because she was doing a good deed and came in contact with
AIDS-infected blood.
I don't allow my children outside without supervision anymore.
I don't want them to get into something over at that house. I
told them to stay away from there. Not only do these people have
AIDS, but they may be drug abusers too. One of the other folks
in NAAH, Fred Lang, said that his kid came home one afternoon
with a syringe. Fred asked him where he found it and his child
replied, "Next to the AIDS house." I consider this an
infringement on my family's right to enjoy our home and our living
space, not to mention a potentially serious threat to our safety
and well-being. Knight has said that "Our House" doesn't
take IV drug users, so that means the residents are probably all
gay.
"Our House" has two vans. One of them is oversized and
has a commercial license on it. It is painted on the outside with
advertisements about AIDS. The residents drive the vans around
town and park them on the street or in their driveway. People
slow down to read what is written on the van when they drive by.
I think the fact that "Our House" doesn't try to keep
its purpose a secret increases the number of curious people walking
and driving up and down the street. I worry that the drivers might
become distracted and not see the kids playing nearby. That big
van, with the advertisements, is a commercial vehicle and has
no business being parked on a residentially zoned street. The
residents handed out condoms. I know this because some of the
teenage kids on the block were bragging about how they got them.
I often see people going in and out of "Our House."
There is a Georgetown Medical Center van that comes to the house
at least three times a week. Sometimes it picks up people from
the house, and sometimes people from the van get out with what
appears to be medical bags. They go into the house for about an
hour or so, and then leave. Once a week, usually Thursdays, they
must hold a meeting of some sort, because a lot of people show
up, park up and down the street, and go into "Our House"
for a few hours. Ambulances are constantly at "Our House."
It's always an upsetting feeling to see ambulances racing up your
street and to have lights flashing and blinking through your windows
at any time of the day or night. It is rare that I get to sleep
through the night without a disturbance of this sort. One time
they carried someone out in a body bag. My oldest child asked
me what was going on. I found it difficult to explain that to
him. Children shouldn't have to be unnecessarily exposed to death
and dying or ambulances and hearses on a regular basis. Other
than to be wheeled in and out on hospital beds and wheelchairs,
the residents don't seem to get out that much. They don't do household
chores like mowing the lawn, themselves. They have groceries delivered
to the house. Most of the people on Clover Street have lived on
the block for a few years. We all know each other and socialize.
We have an annual summer block party. We get a special permit
and close the street to cars and set up picnic tables in the street
in front of our houses. We have food and music. Last summer we
were all having a lot of fun at the block party until an ambulance
approached the street. We had to quickly pull away everything
we had set up on the street so that the ambulance could get through.
It went to "Our House" and they took one of the residents
from the house to the hospital. It really put a damper on the
mood of the party. The party never quite got its steam up again
and everyone went home. No one wants to organize this year's party.
We lived in a nice, single-family residential neighborhood before
Knight came in and opened up "Our House." I want to
be able to have my children play outside without my worrying about
them. I want to be able to socialize with my neighbors without
worrying about seeing ambulances and bodies in body bags. I don't
want the property value of my house to decrease because the house
across the street has fire escapes, ramps, and hippie vans around
it. Furthermore, I don't want my street being a freak show, with
people slowing down and stopping to look around, causing traffic,
noise, and parking problems.
Having a house full of people with a communicable disease like
AIDS on a street zoned for single-family residences is a threat
not only to the neighborhood, but to the entire community. It
should not be allowed. I don't want to wait until someone gets
AIDS from a resident of "Our House." I am here today
to save lives.
Statement of Dr. Mel(anie) Brown, Medical Expert for NAAH
I am Dr. Mel(anie) Brown. I am an epidemiologist, or a doctor
who studies how diseases affect large groups of people. I received
my medical degree from George Washington University Medical School
and my master's in public health from Johns Hopkins University.
I have worked for seven years as the medical epidemiologist at
B?Well Pharmaceuticals. I am being paid $1,000 by the plaintiffs
to testify today.
AIDS is caused by a virus now named the Human Immuno- deficiency
Virus, or HIV. The virus attacks an individual's immune system,
leaving the patient unable to fight off infections that people
with normal immune systems can easily fight. Because the patients
have a poorly functioning immune system, they die of infections
as well as from the AIDS virus itself.
Early in the history of the AIDS epidemic, it was felt that this
was a disease of homosexual men. However, now most new cases are
in intravenous or IV drug users. There are increasing numbers
of cases of people with AIDS who do not belong to either of these
"high risk" groups. And it is now felt that anyone is
at risk for "catching" AIDS. It is known that sexual
contact with an infected individual is one of the common modes
of transfer of HIV. Contaminated blood is also a very common way
of transferring the infection. This is why IV drug users are so
frequently infected, because when they share needles, they are
physically transferring someone else's blood into their bodies.
Some people got AIDS from infected blood transfusions in the hospital.
These days the United States' blood supply is tested for the AIDS
virus. Also, people who practice "high risk" behavior,
that is, unprotected sexual contact or IV drug use, are asked
not to donate blood. For these reasons, the U.S. blood supply
is now considered safe. HIV has been isolated from tears and saliva
of AIDS-infected patients as well as infected blood, semen, and
vaginal secretions. Therefore, all these secretions might be considered
infectious.
The Centers for Disease Control in Atlanta estimates that the
number of people infected with the AIDS virus in the United States
is about 1.5 million. Since 1981, there have been 101,000 cases
reported of actual AIDS, of which about 60%, or 60,000, have died.
So the magnitude of this epidemic and its threat to our society
is quite clear.
I believe that concentrating a group of AIDS patients in the middle
of a residential community is ill-advised. While it is true that
medical science has made major advances in our understanding of
AIDS, there is still a lot we do not know. Some would say that
casual contact with an AIDS patient is not dangerous. I would
disagree. Because of the long period of time between testing positive
for HIV and coming down with AIDS, any statistics mentioned, like
the ones above, are possibly gross underestimations of the magnitude
of the epidemic. We really do not know the risk of getting AIDS
through casual contact because not everyone who has had casual
contact with an HIV-infected individual has been tested. Symptoms
may not appear for 5 to 10 years after contact is made. Therefore,
I think the medical community is conveying an optimism that is
not warranted at this time. We need more studies of large populations
over a long period of time before safe conclusions can be made.
"Our House" is a product of the medical community's
optimism. This unregulated facility is allowed to give fairly
sophisticated care to a group of patients with AIDS.
According to information about the medical care required by patients
in "Our House" that Eva(n) Buttle has provided to me,
"Our House" is operating as a health care facility or
a community-based residential facility. Because of the residents'
medical needs, "Our House" should be regulated as a
health care facility or a community-based residential facility.
Everyone in the house has a common need for treatment. Knight
provides them with medical services and treatment. Because the
home is not regulated, we can't be sure that the care "Our
House" provides is sufficient. For instance, we are not sure
whether the occupants or employees at "Our House" take
enough care in dealing with their garbage and medical waste. We
are not sure whether persons working with patients' secretions
are protected from transmittance of the disease. Unless "Our
House" is regulated according to D.C. health codes, unqualified
and unlicensed people can be hired to provide care. This puts
both the patient and the worker at risk. The workers at the house,
like Eva(n) Buttle, really did not have a good understanding of
the illnesses of the people they were caring for. Knight is not
a licensed health care professional, nor was Mr/s. Buttle.
I caution that allowing homes such as this to operate without
any certification or supervision could pose a threat to the community.
The AIDS epidemic is a serious one and unless we take every necessary
measure to keep it in check, homes such as "Our House"
will prove to be a breeding ground for AIDS.
Statement of Eva(n) Buttle, Former Cleaner, "Our House"
My name is Eva(n) Buttle. I worked at "Our House"
at 4210 Clover Street, N.W. from April 5, 1989 until September
21, 1989. I was employed as a house cleaner. I came to the house
for an interview and met Vic(kie) Knight. S/He spoke to me about
what the job would entail. S/He made it clear to me that the other
five people living in the house had AIDS. I didn't know too much
about the virus at the time, but s/he reassured me that if I followed
some guidelines s/he set out for me that I would not be at risk
of getting the disease. I was hesitant at first, but the pay was
extremely good, although there were no health benefits included.
I never really understood who was running this facility. At first
I thought it was part of Georgetown Hospital; then I thought it
was some clinic or a social service organization.
The house appeared brand new, both inside and outside. In fact,
Mr/s. Knight told me that s/he had been living there just a short
time and that the other residents had just moved in, I had never
seen a house quite like it in a neighborhood . It looked like
a small hospital that was set up to make the patients feel like
they were still at home. My niece had her baby in a room like
that at Georgetown Hospital.
My tasks included cleaning the house, doing the laundry, giving
out medicine, and various other tasks related to the house. I
used a lot of Clorox in that house. Sometimes I had to clean out,
wash, and sterilize bedpans. I washed the clothes, sheets, and
towels for the house. The sheets were often soiled or stained
with blood, dressings from bandages, urine, and feces. I guess
that's why the pay was so good. I really had a lot to do in the
house. I was kept busy from the moment I stepped into the house
until the time I left at the end of the day. I was told to wear
gloves when I cleaned, but I didn't like the way they felt on
my hands. I only wore them when I cleaned the bedpans, the dishes,
and the bathrooms.
There are so many rooms in that house. Cleaning one kitchen is
time-consuming as it is, but Knight added another kitchen to the
upstairs of the house. When I prepared meals I sometimes had two
sets of meals going at the same time. Often, I had to carry food
upstairs to the other kitchen. I frequently served meals to the
residents in their rooms.
It was difficult for me to manage all the tasks alone. Knight
was a demanding boss. I couldn't even throw trash out without
having to try to remember in which container that particular waste
was supposed to be placed. Needles had to go in a special plastic
container. Medical wastes went in a special colored bag. Making
the beds was a greater chore than usual. The beds were large and
heavy. Because they had wheels on them, you had to make sure the
brakes were locked so the beds wouldn't roll.
There were often other people working in the house. Sometimes
there were visitors. Doctors came every once in a while. Nurses
were there more often; they would come in the evening as I was
leaving. I met the dietician a number of times, and a social worker
came to the house every few weeks. There was a physical therapist
there for a few weeks working with Terry Campbell, one of the
residents. He had taken a fall and had hurt himself. The therapist
was trying to help him to build up his strength. I know what all
these people did because I would ask them.
Most people who lived in the house and those I met who worked
there were very nice to me. The residents of the house were so
skinny, I always wanted to feed them to fatten them up. They were
a very quiet group. It was really upsetting to me to see one of
them die in the short time I worked for "Our House."
I became so emotional I couldn't work there anymore.
Knight says that s/he fired me, but I quit. I wasn't hired as
a nurse. I didn't want to work in a hospital. "Our House"
was too draining both physically and emotionally.
Statement of Vic(kie) G. Knight, Trustee
My name is Vic(kie) G. Knight. I live at 4210 Clover Street, N.W.,
Washington, D.C., also known as "Our House." The house
was previously owned by John King, who, upon his death, left the
house in trust to me as a residence for persons with AIDS. I am
the administrator of the trust. Since the time of his death in
1988, I have been making sure that John King's wishes, as stated
in his will, are carried out. I have been living in the house,
renovating it, refurnishing it, selecting persons to live in the
house, and making arrangements, both legal and functional, so
that the residents are comfortable. I do not hold another job.
Running the house, administering the trust, and running the educational
aspect of the house take up a great deal of time.
When I was ready to start interviewing people to move into the
house, I notified the local AIDS clinic, which referred people
to me. I interviewed a lot of people, and it was difficult to
select only five. I wanted to have a group of people who understood
the mission of the house. They had to be interested in communal
living and developing a sense of being one household or a family.
I wanted to take people who really needed a place to live. I would
not take any intravenous drug abusers. If the residents are physically
able, they share household chores, plan activities together, and
if they wish, share meals.
I never applied for a special use permit or a variance from the
zoning board because I never saw a need to do so. We are a single
housekeeping unit, functioning as a family. It shouldn't matter
that 5 of the 6 people in the house are suffering from AIDS. Everyone
in a household could have cancer or other various ailments. We
don't feel we should have to hide the fact that residents of our
house have AIDS.
The house originally had four bedrooms. I have made three additional
rooms in the basement. One serves as my room, one serves as my
office/study, and one serves as a guest room. I have enlarged
the kitchen and added an extension. The extension has an extra
bedroom in case we need a person to stay with us at night when
a resident is very ill. It also serves as a storage room for supplies
and equipment.
I have widened the entrance and have added a ramp to the house.
This allows a hospital-size bed or a wheelchair easy access. The
house has two stories. I have attached a fire escape and a door
on the second floor leading to the fire escape. Inside the house,
I have installed a wheelchair lift for easy access to the second
floor. I have put in a small kitchenette upstairs so that residents
who want to prepare something to eat or drink won't have to climb
the stairs or use the lift.
The renovations I have made are to make the house aesthetically
pleasing and comfortable for the residents. They become extremely
weak during the last stage of the disease and often cannot leave
their beds. Therefore, I have had skylights installed in nearly
every bedroom of the house so they will able to look up at the
sky.
Our residents are at different stages of AIDS and each has chosen
his or her own type of care. Most want to remain in the house
through their illness. We have had visiting nurses come and stay
at the house when necessary. Georgetown Medical Center sends a
van to transport the residents to the hospital once a week. Doctors
make house calls when a resident is too weak to travel.
A dietician comes to the house twice a week. She goes over a personal
nutrition plan with everyone in the house. She is in charge of
stocking the kitchen with the appropriate groceries. She prepares
the evening meal for the house twice a week.
I have hired someone to come every day to clean the house and
help with other household tasks. I have had a few people work
for me in this capacity. Eva(n) Buttle was one such person. We
no longer employ her. I had to let her/him go because s/he was
very forgetful and really didn't do a very good job cleaning.
It's important that the house is clean because the residents are
susceptible to colds and flu and the like. S/He was also always
forgetting who took what medication and when the medicine had
to be taken. I couldn't afford to have her continue to make such
mistakes. When I interview people to clean the house and do the
laundry, I tell them that the residents in the house have AIDS.
I tell them what this means in terms of their obligations and
risks. I explain to them precautions they should take, and I provide
them with the Centers for Disease Control's Infection Control
Guidelines for Home Care. I found Mr/s. Buttle cleaning without
gloves a few times, and had to remind her to put them on. She
said she didn't like the way they felt on her hands.
We take precautions to protect ourselves, the people who come
in direct contact with the residents in the house, and the community.
For example, I knew that the neighborhood was resistant to having
"Our House" established in its midst. Therefore, I arranged
to have a private trash company take away our refuse. The company
comes twice a week. One of our residents is diabetic so we have
to dispose of needles. We have special containers for needles,
which we take to the local clinic for proper disposal. We put
very little trash out for curbside pickup. We put our newspapers
out on the curb as part of the recycling program.
On Tuesday evenings, we hold an AIDS comfort meeting in "Our
House." It's for family, friends, and AIDS sufferers themselves.
It's a social group to help comfort people. I feel that the members
of NAAH are discriminating against persons with AIDS. It is not
just the mere fact that we are here in court today, but there
have been a number of other incidents that demonstrate their intolerance
for persons with AIDS. For example, last summer they had their
annual block party. The entire block was invited to participate,
except for the residents of "Our House." You should
have seen the picnic tables lined up next to each other up and
down the block with a big gaping hole right in front of our house
where our picnic table should have been. They utilized that space,
though. It became the dance area. Speakers were set up facing
right towards "Our House" and the music was blaring.
It was quite disturbing to us because some of the residents needed
to rest. We have also had some threatening phone calls to the
house. Once, someone sent a bunch of dead roses to the house.
We tried to trace the source but we were unsuccessful.
The number of people with AIDS who need housing is growing all
the time. Perhaps it is because they have no family or they have
been rejected by their family. Maybe they cannot afford to live
on their own any longer. Possibly they cannot take care of themselves
any longer, or do not want to be alone. Whatever the reason, the
people in "Our House," my new family, have chosen to
come and live together under one roof. I'm here to see that they
can live here for as long as they wish and as long as they live.
I am not running a health care facility or a community-based residential
facility. We are a family. If a member of your family got sick,
you would do everything you could to take care of them. That is
what "Our House" is about.
Statement of Dr. Paul(a) Moss, Medical Expert for "Our House"
I am Dr. Paul(a) Moss. I am a physician with a specialty in
infectious diseases. I am presently on the faculty of Georgetown
Medical School, where I completed my residency and infectious
diseases. I am not being paid for my testimony here today.
Through the advances of medical science we have developed an excellent
understanding of AIDS. New therapies are being developed every
day that will extend and improve the quality of life of HIV-infected
patients. Many in the field believe that a vaccine against HIV
will be developed in the next 10 years. As far as epidemics are
concerned, this is an incredibly rapid time frame in which an
infectious agent is described, treated, and potentially cured.
What the public needs to understand is that AIDS is a chronic
disease, causing a long-term illness. HIV is not a quick killer.
When someone gets exposed to an HIV-infected individual either
through unprotected intimate sexual contact or through infected
blood products, there is a chance that person has been infected
with the AIDS virus. It is not clear how much of an exposure is
required to get infected. Once someone is exposed and possibly
infected with HIV, there is a time lag of months until that person
test positive for HIV exposure by our standard testing procedure.
Once someone tests positive for HIV exposure, that does not mean
he or she has AIDS. However, our society does not distinguish
between the two, and therefore both types of patients are wrongfully
and equally discriminated against in housing, work, etc. A person
can test HIV positive for years and be healthy and normal. But,
important to note, a person is able to pass HIV infection to others
by unprotected sexual contact or by giving contaminated blood.
In about 5 to 10 years after exposure to HIV, the patient will
have a severely weakened immune system and will carry the diagnosis
of AIDS. At this stage and even prior to the diagnosis of AIDS,
there are excellent medications that can delay the onset of the
disease and extend a patient's life.
I have had residents of "Our House" as patients, often
before they became residents of the house. I think it is wonderful
that the house was bequeathed for the purpose of enabling persons
with AIDS to live together in a residential setting, and attempt
to continue to live out their lives in a sense of normalcy. "Our
House" has terrific facilities for persons in need of home
care. It is also cozy and sunny. I have been to the house on a
number of occasions. I have visited it both professionally and
socially. I am committed to seeing "Our House" remain
in its present location.
I do not consider "Our House" to be a medical facility.
It merely provides the care one would give a family member who
no longer requires hospitalization or a nursing home. In fact,
a family could provide even more care if they so desired. Because
of the overcrowding and expense of hospitals, care is more often
provided in home settings. One can hire around-the-clock nursing.
Intravenous antibiotics can be given in the home. It is not unheard
of to have a patient on a respirator, or more simply put, a breathing
machine, in the home. Given the costs of health care in the hospital,
our society should get used to these changes. Caring for these
types of patients in a community setting literally costs a fraction
of what it would cost to keep them cooped up in the hospital.
"Our House" does not pose a health risk to the community
or to the people who work there as long as current contact recommendations
are followed. There is no evidence that HIV is spread by everyday
contact. The Surgeon General's Report on AIDS states that if ".
. . family members shared food, towels, cups, razors, even toothbrushes,
and kissed each other . . ." there would be almost no chance
of spreading AIDS. The residents at "Our House" follow
much stricter hygiene guidelines. Health care workers come into
contact with AIDS patients and their infectious materials more
often than would be expected from common everyday contact. The
Surgeon General's Report also states that of 750 health care workers
who had possible exposure to HIV-infected body fluids, only three
tested positive for HIV exposure. These three had all reported
being accidentally stuck with a needle contaminated with infected
blood. It is therefore felt that the AIDS virus is not transmitted
by casual contact. The incident in which Terry Campbell fell and
was assisted by a good Samaritan is a troubling event. While it
is unlikely that this woman who assisted Mr/s. Campbell was infected
with HIV, especially if s/he had no open cuts on her/HIS hands,
it is a possibility. Health care providers would recommend close
follow-up. You should be as cautious when coming in contact with
the blood of your closest friend as you are when dealing with
a stranger's blood. However, the community needs to be taught
that contact with anybody's blood is a potentially dangerous event;
besides HIV, many other viruses, like hepatitis, could be transmitted.
"Our House" is trying to educate the community about
these hazards.
Statement of Terry Campbell, Resident of "Our House"
My name is Terry Campbell. I live at 4210 Clover Street, N.W.,
also known as "Our House." I have AIDS. I am also a
hemophiliac. Basically, that means that when I get a cut and start
to bleed, the clotting agents in my blood do not work, and I can't
stop bleeding. I bleed really easily, too. I require transfusions
of clotting agents on a regular basis to prevent bleeding. I got
AIDS from a transfusion that was contaminated with HIV. Before
"Our House" opened, I spent a lot of time in the hospital,
even after I really didn't need to be there. When I was in the
hospital, I couldn't go outside, I had few visitors, and they
could only come at certain times. I was really bored and frustrated.
I met Vic(kie) Knight at a meeting at the local AIDS clinic. S/He
told me that s/he was opening "Our House." I applied
to live there and was accepted. I have been living in "Our
House" since it opened.
It's been a really good experience, that is, if you have to have
AIDS. I finally have a home, a place to feel comfortable. I feel
we are a family. People are supportive of each other, and care
for and about each other. I don't want to live by myself. I am
afraid of having something happen to me and not having anyone
there to help me. I don't want to die alone. I want to live out
my life doing the everyday things I have always strived to do.
I don't want to be a burden on my parents.
The house is run as much like a household as possible. We share
in the chores, and we have meals together. We sit around and talk,
listen to music, read, and enjoy each other's company. We try
to encourage each other to get out of bed and come to the dining
room for meals, or to sit in the living room to be together, to
get a change of scenery. We have some beds on wheels so that we
can wheel someone into a room, so we are not alone.
The house is extremely comfortable. All the doorways are accessible
for those confined to a wheelchair or a bed. The rooms have a
lot of light that comes through the windows and skylight. There
are handrails along the walls throughout the house so you can
have support as you are walking. Vic(kie) Knight did a great job
of working with the architects in renovating the house.
It is quite a task to run the house. We all take precautions to
make sure things that are supposed to be sterile are, and to avoid
exposure of anyone from the outside to AIDS. Keeping track of
who gets what medication and when, is a job in itself. Waste has
to be disposed of in specific containers with lids, and we have
colored bags for certain kinds of waste. A trash company takes
the garbage away a couple of times a week.
It's a little weird to look at each other and know we're all going
to die. Everyone does die, though. We'll just die sooner than
most in our age group. It's hard to see people die, especially
those close to you. We at least have each other. We don't have
a lot of visitors. It's difficult for some of our friends and
families to see us getting so skinny and becoming so weak.
We have two vans of our own. One we use for transportation and
the other we use to educate the community about AIDS. The educational
van is decorated with brightly colored letters that say "Aide
with AIDS." It catches a lot of attention. I ride in the
educational van twice a week for about three hours each day. I
answer questions and talk to people about AIDS. We believe that
much of the resistance to homes like ours and other negative feelings
towards those suffering with AIDS could be dispelled if people
were more informed on the topic. We answer questions and, if requested,
we pass out brochures, condoms, and addresses of places where
people can get counseling and/or screening for the HIV virus.
Another van from the hospital comes to take me for my checkups.
I usually go about once every other week.
Other than going out in the educational van and to the hospital
for treatments, I stay in the house a lot. Sometimes I go out
for short walks, but I have someone walk with me. I went out for
a walk a few months ago by myself and I fell down and started
bleeding and ended up in the hospital again. I was very fortunate
that day that some person driving by stopped to help me and called
the ambulance. None of the neighbors did anything to help me,
or even to contact anyone in "Our House." I could have
been lying there bleeding for quite a long time. If it were not
for that person stopping to see what was wrong, I would have bled
to death. Fortunately, I'm well enough to be here today.
STIPULATIONS: Both parties agree to the following:
1. The architect's sketches of 4210 Clover Street, NW, labeled A and B are authenticated photocopies of "Our House" before and after the renovations took place, and are admissible.
2. The portion of the Infection Control Guidelines for Home Care, labeled C and D, are authenticated photocopies of the Home Care Guide referred to in witness statements and is admissible.
3. Photocopies of Gaskin's chart of activity at "Our House,"
labeled E, are authenticated photocopies and are admissible.
INFECTION CONTROL GUIDELINES FOR HOME CARE
There is no evidence of transmission of the Human Immunodeficiency Virus (HIV) by normal household contact. Persons infected with the virus can be cared for safely in the home environment. To prevent accidental exposure to any pathogens, including HIV, home health workers should implement infection control procedures to protect both themselves and their patients. All patients should be treated as potentially infectious, requiring universal blood and body fluid precautions. Anyone providing personal care services, including family members and friends, should follow the recommendations and procedures given below.
A. Planning and Preparation
The home health care worker should plan in detail all care activities to be performed. Plans should include measures to deal with unexpected events and emergencies. Thorough preparation should be made and needed supplies and materials readied before engaging in any task. As a minimum, the home care worker should have on hand the following:
1. Non-sterile gloves
2. Disposable goggles/protective eyewear
3. Disposable face mask
4. Disposable gowns or aprons
5. Protective airway device
6. Handwashing germicide
7. Puncture proof container for sharps
8. Plastic disposal bags
9. Sterile gloves and supplies (as care requires)
10. Container of household bleach or other approved disinfectant
B. Handwashing
Handwashing is the single most important way to prevent the spread of an infectious organism. Soap and water or an acceptable germicidal hand washing solution should be used before and after all aspects of direct client contact. Hands and other skin surfaces should be washed immediately and thoroughly after contact with blood and body fluids. Hands should be washed after removing gloves.
C. Gloves
All workers should routinely use appropriate barrier precautions to prevent skin and mucous-membrane exposure when contact with blood or other body fluids is anticipated. Gloves should be worn for handling blood, urine, excretions, secretions, open lesions, items or surfaces soiled with blood or body fluids. Gloves should be worn for drawing blood, starting intravenous lines, handling specimens, mouth care, suctioning, and any patient care procedures in which the worker's hands can be in contact with blood or body fluids containing blood. Soiled gloves should be discarded in plastic trash bag. Gloves which are punctured or ripped should be replaced with an intact pair.
D. Gowns
Gowns or aprons should be worn during procedures that are likely to generate splashes of blood or other body fluids or when soiling of clothing is likely to occur.
E. Handling of Needles and Other Sharps
All workers should take precautions to prevent injuries caused by needles, scalpels, razors, and other sharp instruments or devices during procedures. In using sharps, the worker should not be hurried, should lay out all materials prior to use, and, should follow step by step procedures. Extreme care should be exercised when handling sharp instruments after procedures, cleaning used instruments and during disposal of used needles. To prevent needlestick injuries, needles should not be recapped, purposely bent, broken, removed from disposable syringes, or otherwise manipulated.
All sharps including syringes, needles and razors should be discarded in puncture resistant, leak proof containers. These containers should be placed in the area of use. Leave containers in the patient's home until three quarters filled. Do not stuff containers or force items into them. For know intravenous drug users, do not leave needles and/or syringes, clean or used, in the home. Used needles and syringes should be placed in a puncture resistant container removed from the home and discarded off the premises in accordance with the home health agency's policy and local and state regulations.
If sharps cannot be disposed of by incineration, the containers should be filled with a freshly prepared 1:10 bleach (5.25% sodium hypochloride) solution and disposed of as regular trash.
F. Handling and Disposition of Other Materials
Soiled materials such as dressings, gloves, sanitary pads, diapers, intravenous tubing, suction catheters, and enema tubes that are contaminated with blood or body fluids containing blood should be placed in a plastic bag and saturated with a freshly prepared 1:10 bleach solution. This bag should then be placed in a second plastic bag and sealed. The double bag can then be disposed of as regular trash.
Nondisposable items, such as intravenous poles and pumps should be wiped with an appropriate disinfectant recommended by the technology company supplying the equipment. Cleansing routines should be done daily, after any splashing with blood or body fluids, prior to removal from the home, and before the use with another patient.
Blood and other body fluids can be flushed directly into the sanitary sewer.
G. Clean-Up Spills
Disposable gloves should be worn and disposable cleaning cloths used to clean up spills of blood and other body fluids. Surface debris should be removed first; then an appropriate disinfectant or a 1:10 solution of common household bleach should be used to disinfect the area (instructions provided by the disinfectant manufacturer should be followed.)
H. Laundry
Linen and clothing soiled with blood or body fluids should be placed and transported in leak-proof bags. Laundry should be washed with detergent on the hot cycle. Adding one-third cup household chlorine bleach per ten gallons wash water will assure disinfection. There is no epidemiologic evidence of HIV/HBV transmission from soiled laundry. The effect of dilution, pH changes, and heat while laundering renders the risk of such transmissions negligible.
Day of the Week Ambulance came to "Our House" # of
cars or people at "Our House" to look at house or van
# of non-residents entering the house # of residents seen walking
outside on Clover Street
Sunday, June 11 AM AM
PM PM
Monday, June 12 AM AM
PM PM
Tuesday, June 13 AM AM
PM PM
Wednesday, June 14 AM AM
PM PM
Thursday, June 15 AM AM
PM PM
Friday, June 16 AM AM
PM PM
Saturday, June 17 AM AM
PM PM
TOTAL AM AM
PM PM
Sunday, June 18 AM AM
PM PM
Monday, June 19 AM AM
PM PM
Tuesday, June 20 AM AM
PM PM
Wednesday, June 21 AM AM
PM PM
Thursday, June 22 AM AM
PM PM
Friday, June 23 AM AM
PM PM
Saturday, June 24 AM AM
PM PM
TOTAL AM AM
PM PM
SIGNED: NOTARY PUBLIC;
updated: 8-08-05
Prof. J.