The worst house, she said, was one in the 100 block of S. Arlington Ave., where 10 women shared one bathroom. Because there was no kitchen stove, they used a hot plate and microwave to cook.

"And it had rats," Sturgill said. "And it flooded." Residents slipped out at night through a basement door and "wouldn't be there in the morning." BBH patients no longer live in the house.

For her, managing a house brought a sense of responsibility: "People are looking up to me, so it made me stay on the right path," she said. "It made me feel like a role model."

But Stephen Brown, who took on the manager role with trepidation, eventually found the stress too great. He tired of having to calm quarreling residents. It irked him when he had to ask dealers to stop selling drugs in the alley and had to report the same resident twice for using heroin in the bathroom.

His fears never subsided during the weeks in 2008 when he ran the house on Fulton Avenue. Most worrisome was guarding the key to the medication cabinet. "Suppose my mental situation goes off and I say, 'Look, man, take all you want.' Or somebody gets aggravated," he said.

"You won't take a person who's a patient and put them responsible for another patient," he said, the words tumbling out and his voice growing louder. "That don't make no sense, because I take medication just like everybody else."

Today, Brown lives in supportive housing outside BBH's network. He works as a cook for a catering company in Baltimore. Despite unpleasant memories of being a manager, he speaks highly of his therapy at BBH and says he hasn't used drugs since he began his third stint there in spring 2008.

Smith, BBH's housing director, said she always looked for rental houses that were safe and comfortable, with decent kitchen and laundry facilities, and common areas for watching television. Last year Smith gave The Sun a tour of a three-story house on Calhoun Street. At the time, 12 men lived there and five were sharing one bedroom.

Given rampant drug dealing in the area, she encouraged patients to walk in groups. She urged them to avoid drug "holes" by sticking to busy streets or to ride in a BBH van.

In choosing house managers, BBH applied what Smith called "pretty rigorous criteria. At first you have to have at least 60 days of clean time. Then you have to have been a leader in the community, group [therapy]-compliant, medication-compliant.

"Once they're house manager," she added, "they're put in charge of monitoring the patients in the house."

The middlemen

Rather than buy houses, BBH rents them from private owners. For years it used a middleman named Mark Spence to find rental houses in Baltimore. Tax filings show the nonprofit has paid Spence more than $2 million since 2004 for housing services.

Terry T. Brown, the BBH vice president, said last year that the relationship with Spence had changed. "He's now finding we don't do as much business with him as we did in the beginning," Brown said.

Even so, BBH paid Spence $182,000 last year.

Brown and Smith said they were unaware that seven years ago, Washington's mental health agency ordered all mentally ill clients pulled out of Spence-run homes in the District of Columbia.

"This action has become necessary due to observance of deficiencies during site visits," wrote Edith Makenta of the District of Columbia's Department of Mental Health, in a 2003 memo. She cited "housing safety issues/lack of repairs, issues with money and food, seizure of consumer personal belongings [and] changing of door locks prohibiting access to their housing."

Spence, who filed for personal bankruptcy last year, could not be reached for comment.

Cesare Vaughan was one of the property owners who did business with Spence in Baltimore. He said their association began several years ago when Spence rented four of his rental properties in succession, filling them with BBH patients. BBH paid Spence, and Spence in turn paid monthly rent to Vaughan.

Vaughan said doing business with Spence initially carried great appeal. "I had three-year leases from him, guaranteed rent," he said. "It's almost like you're paying my mortgage for me."