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Irene Kaplan was on her way to a doctor's appointment on July 15 when she started feeling dizzy. She had the driver turn around and take her home, but she didn't make it past the lobby, she said. She started vomiting and spent the rest of the day in the emergency room, hooked up to an IV. She blames it on the medications she takes for depression–Prozac and Wellbutrin–along with the summer heat.

Kaplan lives in Surf Manor Home for Adults in Coney Island, and doesn't have air conditioning. At times, the temperature in her room has soared to 90 degrees. “I sit up there without even moving and I have sweat dripping off my nose,” she said. She'd love to have A.C., she added, but it costs $60 extra per month, too much considering her Supplemental Security Income (SSI) allowance is only $130.

Advocates for the mentally ill say residents like Kaplan shouldn't be forced to make that choice. They're asking the state to fund air conditioning for all adult homes and require operators to keep rooms cooled to 72 degrees.

“Since these are state licensed facilities, we strongly believe that it's the state's responsibility to ensure that air conditioning is available to residents free of charge,” said Tanya Kessler, adult home project director at the Coalition of the Institutionalized Aged and Disabled. “The only way that'll happen is if the state funds it.” Kessler estimates that providing air conditioning to the 30,000 residents of adult homes statewide would cost an estimated $7 million.

The owners of the homes are all for it, said Lisa Newcomb, executive director of the Association of Adult Homes and Assisted Living Facilities, a trade organization that represents 265 homes statewide. “We all take the issue very seriously,” she said.

The New York State Department of Health now requires adult home operators to provide access to an air-conditioned common area and keep other rooms below 85 degrees. But that may still be too high for some residents, Kessler points out. Dozens of medications increase sensitivity to heat, and psychotropic drugs, in particular, are known to interfere with body temperature regulation.

In a 2002 investigation, New York Times reporter Clifford Levy investigated deaths at 26 local adult homes, and found that July and August were often the deadliest months. In July 1999, for example, three residents without air conditioning died at the Leben Home for Adults in Elmhurst. The home is now under new management.

Air conditioning woes plague even the city's better adult care facilities. The Garden of Eden Home in Bensonhurst charges a staggering $125 per person for air conditioning, or $250 per room. As a result, many residents forego the option and, despite window fans, rooms can be suffocatingly hot. Raymond Smith, 62, shares one with his wife Marlina, 60, who has diabetes and high blood pressure, both of which are risk factors for heat-related illness. “I put rags on her head to keep her cool,” he said.

Jay Amsel, owner and operator of Garden of Eden, says he'd be happy to provide air conditioning–as long as the state foots the bill. “Without a doubt, it's a necessity,” he said. “It's not a luxury.” But the cost of energy, equipment and labor is just too high to absorb, he explained, given that SSI pays him $29 per day for each resident. “You don't even break even,” he said. So his staff simply makes sure that residents drink lots of fluids and don't spend too much time in their rooms or outside in the sun.

In a May 25 letter to operators, the Department of Health provided a chart detailing symptoms of heat exhaustion, heat stroke and heat cramps, along with a list of 103 drugs that can increase their likelihood. It encouraged staff to closely monitor residents during the “hot and humid weather.”

That's not good enough, says Gary Levin, a resident active in the Coalition, which is now holding meetings on air conditioning around the city. “If the state came into a building and it was 30 degrees, they would not tolerate it whatsoever,” said Levin. “Why is it they will tolerate a 90 degree building where people have no air conditioning?”