In NY, it is expensive and a pain to get the town and BD of Health involved once a septic field has to be repaired/replaced.  

I know my ROE will be terrible, but I'll have a very health balance sheet and P&L and at a basic level that's my goal.

Re-evaluate the trust and the attorney didn’t tell us initially it can only be used for utilities, cars, health care and other random things but NOT rent.

Much of new health care developments in the city are for various aspects of geriatric care.

Other ideas I've had are perhaps less conventional, such as offering English language classes, providing info for tenants to access free counseling if they have marital/drug/mental health issues, and even hiring tenants to make repairs if they are qualified to do the work and trustworthy individuals.

It is against health department rules to live in a place without utilities. 

I strongly recommend that you strengthen your overall personal financial health before undertaking real estate investing and leveraging yourself with additional debt.

It's bad for our health.

Not to mention the health risks involved with second hand smoke.

Do you have any interest in health care real estate?