Autistic man abandoned at Naples hospital has no place to go

A public guardian and a state agency thought they had a solution for a severely autistic young man whose mother abandoned him more than a year ago at a Naples hospital.

Placement in a local group home lasted four days before the 22-year-old — referred to as “John Doe” in court records — was back at NCH Downtown Baker Hospital, said Patrick Weber, the public guardian in Collier County. 

“In my history I have never quite had a case like this before,” said Weber, the county’s public guardian for 25 years. “Nothing is the same as this case.”

Doe's care requires intensive services in a 24-hour setting, and no group home in Collier is equipped for that, experts say.

The young man can smile and acknowledge people around him but is nonverbal; he can’t speak about his fears and wants, Weber said.

Doe was first taken to NCH in May 2017 for emergency medical care, court records show.

He was hospitalized for treatment and cleared for discharge in mid-August 2017. The catch is that the hospital had no place to send him.

Hospitals are required by state and federal law to follow discharge planning requirements that include making sure discharged patients have access to services that fit their needs. NCH was stuck because Doe’s mother refused to accept responsibility for him.

The hospital racked up a huge sum for uncompensated care and filed a complaint in court to have Doe moved to another setting.

NCH cannot comment on specific patient cases because of privacy laws, but in general, hospitals have a responsibility to use inpatient hospital beds for patients who medically require that level of care, spokeswoman Debbie Curry said.

“Unfortunately, on a somewhat regular basis, many hospitals are put in the unfortunate position of having to address situations involving patients who do not (or no longer) require hospital care, but who are without a safe discharge plan due to a lack of family involvement, funding, or other circumstances beyond the hospital’s control,” Curry said in a statement.

“These situations ultimately result in millions of dollars of uncompensated care annually to the hospitals involved,” Curry said.

Weber said NCH filed the court complaint in hopes of convincing the mother to take responsibility.

“This was a legal battle because of the inactivity of the mother,” Weber said.

The court declared Doe mentally incapacitated and appointed Weber as guardian, and he began working with the Agency for Persons With Disabilities to get involved. The agency agreed, even though Doe did not qualify for benefits.

Doe’s mother sponsored him in June 2016 to come to the United States on a green card. At the time she agreed to take responsibility for him, but she didn’t complete the process of becoming his guardian, Weber said. Court records do not say which country Doe is originally from or his mother's name.

Once APD agreed to pay for services he needs, Doe was moved to a local group home April 23. It didn’t work out. Weber declined to disclose which group home.

After leaving the hospital, Doe was being weaned off an antipsychotic medication. He became physically aggressive, and the group home realized it couldn’t accommodate him. The state agency also does not allow the group home to administer the injectable antipsychotic medication, Weber said.

“He was returned to NCH and having seizures,” Weber said.

The state agency is looking to place him in a more intensive group home that can address people who require a higher level of services.

That type of group home offering intensive behavioral services doesn’t exist in Collier, Weber said. That means Doe will be placed out of the county or will wind up in a state mental hospital in Tallahassee or Miami.

“He’s going to be institutionalized unless his mother agrees to take him home,” Weber said. “He’s never going to live independently. He will require either institutional or family" care.

Karen Govern, executive director of STARability, formerly the Foundation for the Developmentally Disabled, confirmed there are no group homes offering a higher level of services with medical personnel.

“There are none that are intermediate care facilities for people who require regular medications for (conditions such as) diabetes or seizures,” she said.

It is unusual that Collier doesn’t have intermediate care homes; the issues are land availability, costs, objections from neighborhoods and an entity’s desire to open one, Govern said.

Long-term housing is the top concern for parents with a developmentally disabled child, especially when parents get too old to care for the child. Parents also desire for their child, as he or she gets older, to have some independence and /to feel connected, with opportunities for a job and social interaction. 

She knows of one intermediate care home in North Fort Myers because a Naples family needed to place a loved one there.

“Lee County may have more than one,” Govern said. “Housing is part of our long-term strategy, to try and help our members of the community and people with developmental disability. It really is about educating the community about the needs of families.”

She is not familiar with the case involving Doe and has never heard of a family refusing to care for a developmentally disabled loved one.

“That is a very unique and unusual situation,” Govern said.

Melanie Etters, spokeswoman for the APD in Tallahassee, said she is not familiar with the Doe case and could not speak about it if she did because of privacy laws. In general, APD steps in when there is a dire situation.

“We work with a bunch of different organizations to figure out the best option to protect the health and safety of an individual,” Etters said.

In terms of a parent abandoning a developmentally disabled child at a hospital, Etters said she is not aware of that happening.

“It’s a very rare incident, in general,” Etters said.

Weber said he does not know if Doe’s mother has visited him since he has been back in the hospital.

“I do know she has done nothing to pursue taking back guardianship,” he said.

He could not say if her abandonment of him would be criminal.

“There’s not been a complaint to the state attorney’s office for abandonment,” he said.

Samantha Syoen, spokeswoman for the state attorney's office, said the matter would be civil.

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Autistic man abandoned at Naples hospital has no place to go