Friday, October 18, 2019

State: Patient advocates in short supply at long-term care facilities

By Daniel Axelrod

New York and the mid-Hudson are critically short of volunteers to help police nursing homes, according to a new report by state Comptroller Thomas DiNapoli’s office.

The region and the state lack both volunteer and full-time paid ombudsmen, according to the comptroller, who defined the mid-Hudson as Orange, Dutchess, Ulster, Sullivan, Greene and Columbia counties.

Among other duties, New York’s ombudsmen identify, investigate and resolve complaints made by or on behalf of the 160,000 residents living in 1,500 long-term care facilities, including those in nursing and adult homes.

DiNapoli’s auditors found that, as of January, only about 600 of the state’s long-term care facilities had an assigned volunteer ombudsman, leaving the remaining 900 to be covered by just 50 paid full-time ombudsmen. That’s about half the minimum number of full-time staff recommended by state guidelines.

Locally, 40 of Orange County’s long-term care facilities were without an ombudsman as of January, while those tallies were three for Sullivan County and five for Ulster County. And the mid-Hudson’s full-time ombudsmen office had three full-time staff members in 2018 or one-and-a-half fewer than the state recommends.

Without ombudsmen, long-term care facilities’ residents and families can still call a state hotline to make complaints.

But, “Volunteers are desperately needed to make sure the elderly are protected and that they do have someone to go to with these complaints” in person, said Mark Johnson, a DiNapoli spokesman.
Part of the problem is that New York’s volunteer ombudsmen total has plummeted in recent years, falling 37 percent to 562 in 2018 from 890 in 2015.

That decline is attributable to several factors, said elder care expert Richard Mollot, who runs the Long Term Care Coalition, a nonprofit advocacy group. The state also subcontracts with his group to handle the mid-Hudson’s ombudsmen program.

In recent years, the state reorganizing and reducing the number of local offices for ombudsmen is partly responsible for the loss of volunteers, who’ve been asked to cover more disparate areas, Mollot said. The move was done to help the state comply with new federal requirements.

The state’s 15 ombudsmen offices, nearly all of which are run by nonprofits subcontracted by the state, also have spent recent years working harder to ensure volunteers are visiting facilities and logging time collecting complaints, Mollot said.

Those accountability, transparency and training requirements have contributed to a loss of volunteers, Mollot added, some of whom were more like “candy-striper” hospital volunteers, who made occasional visits rather than acting as strong advocates for long-term care facilities’ residents.

DiNapoli’s audit also cited the job’s challenges — volunteers being exposed to neglect and abuse — and the lack of pay. The mid-Hudson’s ombudsmen program has been experimenting with a pilot stipend program.

In terms of a lack of full-time staff locally and statewide, Mollot said the state just isn’t funding ombudsmen programs well enough.

“The answer is more paid staff and funding” for regional ombudsmen offices to hire full-timers, while recruiting and training more volunteers, Mollot said. “The ombudsmen are absolutely critical to protecting the elderly in nursing homes and in assisted living.”

Joe Guyt, 55, of Central Valley, who’s part of a class-action lawsuit filed against the Sapphire Nursing Home in Goshen over the March 2018 death of his 84-year-old mother, said he didn’t even know the facility had an ombudsman.

“Clearly, we need someone to better police these facilities,” said Guyt, who also serves on U.S. Rep. Sean Patrick Maloney’s public committee to improve local elder care.

Full Article & Source:
State: Patient advocates in short supply at long-term care facilities

San Diego Leaders Stress Importance of New Law to Expand Conservatorships

by Lisa Halverstadt

San Diego County Supervisors Dianne Jacobs and Nathan Fletcher / Photos by Adriana Heldiz

Two San Diego County supervisors say the board will soon review whether to pursue a pilot program established by state law to expand court-ordered conservatorships in San Diego, Los Angeles and San Francisco counties.

San Francisco Sen. Scott Wiener’s SB 40, signed by Newsom last week, bolsters previous legislation allowing the three counties to create five-year pilot programs where court-appointed guardians oversee a person’s daily life without a previous requirement that patients try an outpatient program first. Gonzalez last year added San Diego to the original bill, SB 1045, when it came before the Appropriations Committee she chairs.

Wiener hopes the expanded conservatorships will connect more people in need with longer-term housing and care.

The new law requires counties to first seek 28-day conservatorships that link patients with housing and care and then six-month-long conservatorships. Patients are considered eligible after an eighth involuntary hospital stay for psychiatric care in a 12-month period. These holds follow a determination that the person is a danger to themselves or others.

Wiener has said the goal of the legislation is to provide housing and services to “people who cannot be reached effectively with voluntary services.”

Gloria, who is running for mayor, and Mayor Kevin Faulconer separately urged San Diego County leaders to enact the program.

“There’s nothing humane about leaving severely mentally ill San Diegans unsheltered,” Gloria wrote on Twitter. “It’s time [San Diego County] acts to get these people off the streets and into care.”

Faulconer shared a letter he and Elliott had sent county board Chairwoman Dianne Jacob that emphasized troubling numbers he said underscored the need for the program.

“At a San Diego County board conference on October 30, 2018, county staff presented that nearly 70 percent of psychiatric hospitalizations involving patients with a recurring substance use disorder, and that since 2012, emergency department visits for amphetamine and opioids more than doubled,” the letter says.

Supervisor Nathan Fletcher and Jacob responded with a statement that said the board will move quickly to consider how to implement the program.

Full Article & Source:
San Diego Leaders Stress Importance of New Law to Expand Conservatorships

Dancer accused of bilking elderly man she met at club

Chalsey O’Brien, 27, moved in with the elderly man, withdrew $38,000 from his checking account and used his debit card to purchase nearly $13,000 in merchandise online, according to FDLE.

Chalsey O’Brien
A dancer is accused of stealing more than $51,000 from a Volusia man she had met at a club where she worked, according to the Florida Department of Law Enforcement.

Agents from FDLE arrested Chalsey O’Brien, 27, for one count of grand theft of a victim older than 65 and one count of criminal use of personal identification information of a victim older than 60.

In May 2019, the Office of the Attorney General requested FDLE’s assistance to investigate an exploitation case after a family member of the elderly man contacted authorities, FDLE spokeswoman Jessica Clary said.

Investigators said they learned that O’Brien had met the victim at the club in 2018 and moved in with him. From September 2018 to May 2019, O’Brien withdrew $38,448.80 in cash from his checking account and then made unauthorized transfers, Clary said. She did this by using a debit card assigned to the checking account and used the victim’s personal information to purchase $12,951.94 in merchandise online, according to FDLE.

The man didn’t give O’Brien permission to use his identity, Clary said. After obtaining the merchandise, she sold it for cash, according to FDLE.

Additionally, O’Brien transferred money from the victim’s money market account to his checking account by phone to prevent him from discovering the theft, all while continuing to take money from him, Clary said.

O’Brien was booked into the Volusia County Jail and held on $200,000 bail.

The suspect’s has had several run-ins with the law since 2012. Jail and court records show she has been arrested on various prostitution, drug, theft and traffic crimes.

Full Article & Source:
Dancer accused of bilking elderly man she met at club

Thursday, October 17, 2019

Former Vancouver attorney pleads not guilty to theft charges

Miles accused of stealing more than $5,000 from former client

By Jessica Prokop

Former Vancouver attorney MarCine Miller Miles makes a first appearance Tuesday in Clark County Superior Court on suspicion of first-degree theft and first-degree identity theft. She is accused of stealing more than $5,000 from a former elderly client. (Nathan Howard/The Columbian)
Former Vancouver attorney MarCine Miller Miles is accused of stealing more than $5,000 from an elderly woman she had previously represented.

Miles, 76, appeared Tuesday in Clark County Superior Court on a summons for first-degree theft and first-degree identity theft. She pleaded not guilty to both charges, and waived her right to a speedy trial. Her trial is scheduled for March 23.

Judge Jennifer Snider granted Miles release on her own recognizance.

Miles resigned from the Washington State Bar Association in lieu of disbarment in April 2017. Her resignation stemmed from an unrelated case, in which she altered an elderly woman’s will and bequeathed $10,000 to herself, according to the association’s findings. Miles denied wrongdoing.

But in September 2018, the Department of Social and Health Services reported that it had found by a preponderance of evidence that Miles financially exploited and mentally abused another former client — the same victim named in the criminal case.

Among the findings, DSHS found: Miles stole $4,657.11 from the then-94-year-old woman, trespassed in her home, violated the Rule of Professional Conduct by using the woman’s financial information to commit theft, shared her private health information without her consent and harassed her.

Miles’ attorney, Josephine Townsend, previously told The Columbian that Miles did not agree with DSHS’ findings. However, the parties reached a settlement in April 2018, in which Miles agreed to pay the former client $11,000 and not to contact her anymore. The woman has since died.

The case started in December 2016 when Miles’ former client was transferred to a rehabilitation facility. Miles was the woman’s attorney for about 20 years, according to the DSHS report.

In July 2014, Miles prepared two Durable Power of Attorney forms for the woman: one for health care decisions and nomination of guardian, and another for her financial estate. The woman designated a friend, Jackie Sundstrom, to be her attorney-in-fact for health care decisions, and made Miles her alternate if Sundstrom was unwilling to serve. She designated Miles to be her attorney-in-fact for financial estate, and Sundstrom as the alternate. It would only become effective if the woman was deemed to have a disability or to be incompetent, according to an affidavit of probable cause.

“Disability shall include the inability of the principal (victim) to manage property and affairs effectively for reasons such as mental illness, mental deficiency, illness or disability, advanced age. … Disability may be evidenced by a written statement of a qualified physician regularly attending the principal,” the affidavit reads.

In 2016, the woman asked Miles to remove Sundstrom from her will after some property went missing and she blamed Sundstrom. Miles did not follow her wishes, however. Sundstrom later signed a resignation form indicating she didn’t want to be attorney-in-fact for the woman anymore, court records state.

Despite not having the legal authority, Miles made an appointment for the woman Jan. 3, 2017, with her primary care physician. The woman’s longtime family friend and neighbor, Mark Ickert, went with her. They did not know, at the time, who made the appointment, the affidavit says.

Miles showed up a short time later and was reportedly shocked to see Ickert there. She asked the doctor to excuse him from the room, against the woman’s wishes. Miles then pressured the doctor to declare the woman incompetent, making the Durable Power of Attorney valid and putting Miles in charge of her financial estate. The doctor said he had only 20 minutes to evaluate the woman and admitted to not having notes indicating any cognitive impairment. Still, he declared her incompetent, the court document states.

Three days after that appointment, the woman hired Vancouver attorney Thomas Hackett to create a new Durable Power of Attorney and appointed Ickert as the attorney-in-fact. She also revoked Miles’ powers of attorney, which Miles was notified of and instructed not to contact the woman, according to the affidavit.

But on Jan. 13, 2017, Miles requested the withdrawal of $600 from the woman’s Raymond James account to “pay bill for appointment to determine cognitive impairment of client.” Days later, she requested a withdrawal of $4,657.11 from the woman’s account to pay herself, court records show.
On Jan. 23, 2017, a doctor met with the woman and completed a full cognitive evaluation at Hackett’s request. The doctor determined the woman possessed the cognitive capacity to complete and understand the legal documents.

Vancouver Police Department spokeswoman Kim Kapp said in March that a detective from the property crime unit was investigating the case.

Miles was a longtime attorney in Clark County, and prominent on local boards and organizations. According to Columbian archives, she sought election or appointment at least four times to the Clark County District Court bench, in 1986, 1994, 2001 and 2004. In 2006, Miles unsuccessfully ran as a Democrat for county clerk, who is the elected custodian of Superior Court records.

In 1985, she resigned in lieu of termination as a District Court magistrate after at least 1,800 traffic cases she heard were found to have been improperly handled.

Full Article & Source:
Former Vancouver attorney pleads not guilty to theft charges

Three Indiana Judges Face Discipline After Wild Night Ends With Fighting And Gunshots Outside Strip Club

Buckle up, folks because this could possibly be the most wild legal story you have heard in quite some time. When I first read it, I thought I was being pranked. So let's take the time and explain what allegedly happened. Three judges, all from Indiana, found themselves in a fistfight and shoot out after a bout of heavy drinking on the first night of what was supposed to be a weekend of astute judiciary study. This incident occurred on May 1 2019.  Clark Circuit Judges Andrew Adams and Bradley Jacobs and Crawford Circuit Judge Sabrina Bell, are all facing discipline charges now.

This story comes from IndianaLawyer.com. The weekend of May 1, Adams, Jacobs, and Bell attended the Spring Judicial Conference. After checking into their hotel, the trio downed a few Seagram Escapes, some scotch, and eventually a few beers. They went around bar hopping. They ate dinner, had some wine, played some cornhole, and tossed a few game of darts. It was the type of stuff you'd expect  to occur at bars, but perhaps not from this group. They had themselves a ball of a time. The three realized they were the only ones left from conference goers, except a fourth judge, the Honorable Clark Circuit Magistrate Judge William Dawkins, who stayed with them as the night went on.

So this wolf pack of judges decided to stay out, and their night became so rowdy that they wound up at a strip club at 3:00 am. Yes, the folks tasked with imposing wisdom upon society and discerning laws thought it was a good idea to attend a strip club well after midnight, let alone anytime of the day.
“At around 3:00 a.m., Judge Jacobs, Judge Adams, Judge Bell, and Magistrate Dawkins walked to The Red Garter Gentlemen’s Club and attempted to go in, but the club was already closed,” the filings say. The judges’ presence at The Red Garter has been a point of confusion since the shootings, with law enforcement initially saying it was true but later recanting those statements. Clark County Presiding Judge Vicki Carmichael has likewise eluded that their presence at the gentlemen’s club was not certain, advising media on May 1 to beware of certain “inaccurate” reports.
At about 3:15, the judicial officers walked to the nearby White Castle restaurant, and Dawkins went inside. Surveillance footage from the White Castle shows a woman standing with Adams and Jacobs outside the restaurant, though until now her identity has never been confirmed.
“Outside the restaurant, Judge Adams, Judge Jacobs, and Judge Bell behaved in an injudicious manner,” the JQC wrote.
Then, out of nowhere, some random person named Alfredo Vazquez pulls up in an SUV. Vazquez's passenger, Brandon Kaiser, yelled something at the judges. Bell, ever the charmer, gave Kaiser the middle finger.

So, to recap. It's 3:00 am. Two grown men, and one woman whose job it is to judge society are suddenly confronted by two strangers outside a strip club. What happened next? A discussion of originalism or whether or not we have a living Constitution? Nope. A fist fight broke out, because what else is there to do at that time of night.
A heated verbal altercation occurred between the judges’ group (Judge Adams, Judge Bell, and Judge Jacobs) and Vazquez and Kaiser, with all participants yelling (including using profanity) and making dismissive, mocking, or insolent gestures toward the other group,” the JQC wrote. In the filings against Bell and Jacobs, the commission notes neither judge attempted to leave the scene or de-escalate the situation, while Bell “continued to provoke communication with the two men.”
A fight ensued between the four men, with Adams primarily fighting Vazquez and Jacobs primarily fighting Kaiser. At one point, Jacobs was on top of Kaiser, and he eventually remarked, with his fists raised, “Okay, okay, we’re done, we’re done,” or, “This is over. Tell me this is over.”
The, "as Jacobs began to get off Kaiser, Vazquez began fighting him. Meanwhile, as Kaiser tried to get up, Adams kicked him in the back." This was pretty stupid of Adams to do Kaiser shot the Judge right in the stomach.  "Kaiser pulled out a gun and shot Judge Adams in the stomach region," according to Indiana Lawyer. "He then went over to Judge Jacobs and Vazquez and fired two more shots at Judge Jacobs in the chest."

Full Article & Source:
Three Indiana Judges Face Discipline After Wild Night Ends With Fighting And Gunshots Outside Strip Club

Hospice Abuses and Fraud Cause Opposition to Federal Hospice Bill

The Healthcare Advocacy and Leadership Organization (HALO) opposes funding new palliative care and hospice programs until rampant violations are remedied.
 
BEDFORD, TEXAS, UNITED STATES, October 13, 2019 /EINPresswire.com/ -- The Healthcare Advocacy and Leadership Organization (HALO) and a growing number of organizations and individuals are opposed to the federal Palliative Care and Hospice Education and Training Act (PCHETA)—House bill HR 647 and Senate bill S 2080.

HALO supports hospice and palliative care providers who respect the dignity and life of every patient, give honest information to patients and their families, and provide appropriate pain control and comfort measures. For this very reason, we are unable to support the PCHETA.

Existing federal hospice programs are plagued by fraud, poor quality care, rampant abuse, and even intentionally caused deaths. Enacting another federal hospice program, when existing programs are out of control, makes no sense and will only cause more of the same.

The 2019 Office of Inspector General Report of “Vulnerabilities in Hospice” provides proof that HALO's concerns are valid. For facts about hospice fraud see Home Healthcare News "Special Agents Sound Off on Hospice Fraud."

The OIG reports, “Hospices with patient harm cases do not always face serious consequences from CMS [Centers for Medicare and Medicaid Services]. CMS should seek statutory authority to extend beneficiary protections found in other health care settings to hospices and ensure remedies are available to address poor performers.”

The human toll of hospice abuse can be found in articles, letters and internet posts of hurting individuals whose loved ones were allegedly abused or killed by hospice and palliative care providers. Why pour millions more of federal dollars into an education and training program that will likely be designed by some of the very people perpetrating or ignoring this inhumanity to our most vulnerable citizens?

Furthermore, if the PCHETA becomes law, it will finance programs to educate the public about hospice and palliative care, aiming to entice more people into hospice. Such education is unlikely to inform the public about hospice fraud and abuse or to instruct them how to find reputable hospice and palliative care providers.

Bottom line: Hospice and Palliative Care Medicine (HPM) must be cleaned up before any more taxpayer funds are spent promoting it.

For more information: www.halorganization.com

Julie Grimstad
Healthcare Advocacy and Leadership Organization
+1 817-995-1139
email us here
Visit us on social media:
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Full Article & Source:
Hospice Abuses and Fraud Cause Opposition to Federal Hospice Bill

Wednesday, October 16, 2019

Assisted living facility administrator indicted for fraud and embezzlement

By Brandon Moseley

Thursday, a four-count information was filed in U.S. District Court charging a former Oak Landing Assisted Living Facility employee with embezzling money and assets from a former resident at Oak Landing, announced U.S. Attorney Jay E. Town, Special Agent in Charge Patrick M. Davis, United States Secret Service, Special Agent in Charge Rod Owens, Social Security Administration Office of the Inspector General and Special Agent in Charge Thomas J. Holloman, III, Internal Revenue Service Criminal Investigation.

Lisa Talton Wells Daugherty is 52 and lives in Rainbow City. She is a former Unit Coordinator at Oak Landing Assisted Living Facility in Atalla, Alabama.

She has been charged with one count each of wire fraud, money laundering, filing a false tax return, and theft of government property.

The information alleges that while Daugherty was the Unit Coordinator at Oak Landing Assisted Living Facility and used that position to obtained power of attorney from the victim.

Prosecutors allege that Daugherty then arranged for the victim to become a resident of Oak Landing. Beginning in January 2017, after the victim became a resident of Oak Landing, Daugherty used the power of attorney to gain access to the victim’s assets. Daugherty subsequently allegedly transferred the victim’s assets to herself and purchased a primary residence, multiple vacations homes, automobiles, and paid her ordinary living expenses from the victim’s assets.

Daugherty is also charged with embezzling the victim’s Social Security benefits and filing a false tax return. The information seeks forfeiture of a number of assets seized from Daugherty, including cash and automobiles.

“Elder abuse cases like this all too often go unreported and unchecked.” Town said. “The dedication and hard work of the agents investigating this case assures the people of Alabama that one such abuser will spend time as a resident of the federal prison system. In addition, the assets seized will begin to help restore some of the losses the victim sustained.”

“The U.S. Secret Service remains steadfast in its resolve to bring those who would take advantage of the elderly for their own financial gain to justice,” Davis said. “This case highlights the extent that some individuals will go to financially exploit those who are among the most vulnerable in our community. Without the intervention of the U.S. Secret Service, these individuals would have been able to steal millions of dollars, collectibles, personal effects, and property from the victim.”

“Social Security benefits are a lifeline to millions of Americans in retirement. We are committed to pursuing those who misuse these benefits and victimize some of our most vulnerable citizens,” Owens said. “We will continue to work with our law enforcement partners and the U.S. Attorney’s Office to protect elderly and disabled Americans from this type of fraud.”

“Elder fraud is a fast-growing problem in our communities as it disproportionally affects seniors,” Holloman said. “Individuals who seek to exploit our elderly through financial fraud schemes involving trickery, deception and outright theft deserve the wrath of all Americans. IRS Criminal Investigation and all of its partners will remain vigilant in identifying, investigating and seeking prosecuting of those individuals who seek to willfully defraud our most vulnerable citizens.”

If Daugherty is found guilty of all of things she has been charged with, she could potentially be facing lengthy jail time.

The maximum penalties for the charged crimes include the following: Wire Fraud, 20 years and a fine of not more than $250,000 or twice the gross gain; Money Laundering, 10 years and a fine of not more than $250,000 or twice the amount of criminally derived property involved in the transaction; Filing a False Tax Return, 3 years and a fine of not more than $100,000; and Theft of Government Property, 10 years and a fine of not more than $250,000.

The United States Secret Service, Social Security Administration Office of Inspector General, and Internal Revenue Service Criminal Investigation investigated the case, which Assistant U.S. Attorney Davis Barlow is prosecuting.

An information contains only charges. Daugherty still is entitled to presenting a defense before a jury of her peers. A defendant is presumed innocent unless and until proven guilty.

Full Article & Source:
Assisted living facility administrator indicted for fraud and embezzlement

Guardian at center of Florida scandal appeals judge’s ruling that she broke state rules by misusing DNRs

By Monivette Cordeiro

Gerald Manczak, a ward of Rebecca Fierle, said this "do not resuscitate" order was filed without his permission by the professional guardian. (Monivette Cordeiro / Orlando Sentinel)

Former Orlando guardian Rebecca Fierle is appealing a judge’s ruling that she violated state rules by misusing “do not resuscitate” orders on incapacitated clients and improperly billing AdventHealth nearly $4 million for services she provided to their vulnerable patients.

An attorney for Fierle, who resigned as a guardian statewide July 25, filed two petitions Monday asking the state’s Fifth District Court of Appeals to reverse the ruling from Orange County Circuit Judge Janet C. Thorpe and remove the judge from the case.

Fierle’s attorney, Harry Hackney, argues Thorpe overstepped her authority by disciplining his client and wrongly suggesting the Orlando guardian needed permission prior to signing DNRs from the judge or wards’ family members.

“She can consult family and friends to discern what the ward would have done when competent,” Hackney argued. “She is NOT required to get their permission nor the court’s.”

The embattled guardian is under criminal investigation after the death of 75-year-old Steven Stryker, a ward who died at a Tampa hospital after staff were unable to perform life-saving measures due to a “do not resuscitate” order Fierle filed against his wishes and refused to remove.

An investigation by the office of Orange County Comptroller Phil Diamond found Fierle charged AdventHealth, a Central Florida hospital company, about $3.96 million over a decade for services to 682 patients — a financial arrangement not allowed under Florida law without court approval.

In a Sept. 12 order, Thorpe said Fierle violated several state administrative rules, including mandates to avoid conflicts of interest when addressing wards’ needs and a ban on soliciting or accepting incentives from service providers.

“Based upon the Comptroller’s Report, this Court has no confidence in Ms. Fierle’s actions, reliability, or truthfulness as a professional guardian,” Thorpe wrote. “This court finds probable cause to permanently remove Rebecca Fierle from any appointment in Orange County as a professional guardian.”

But Fierle’s attorney Harry Hackney in the appeal petitions argued the judge’s order was filed without a hearing and without giving Fierle a chance to contest the findings.

“The proceedings in question were apparently conducted secretly by Judge Thorpe in chambers after receiving multiple hearsay reports,” the petition said. “Those proceedings still must comply with the Rules adopted by the Florida Supreme Court and not with the whim of one judge.”

The Florida Department of Elder Affairs’ Office of Public and Professional Guardians has “exclusive jurisdiction” over the discipline of guardians, not Thorpe, Hackney said.

“Judge Thorpe had no authority to proceed to make findings of fact regarding violations of law by Rebecca Fierle or to take steps to ‘remove’ Rebecca Fierle as Professional Guardian after she had resigned,” according to the appeal.

Hackney also argued Thorpe “misconstrued” the rules surrounding DNR orders. In her order finding probable cause, the judge said Fierle violated her duty to act in the best interest of her incapacitated clients by placing DNR orders on them without bringing the issue before the court.

“No guardian can ‘place’ or execute a ‘Do Not Resuscitate Order’ because it is a medical order that must be entered by a physician,” Hackney said.

If a patient is incapacitated, the DNR order can be signed by the patient’s health-care surrogate, health-care proxy or court-appointed guardian delegated to make medical decisions, he wrote.

Thorpe in her ruling cited a provision in Florida’s Administrative Code governing the withholding of medical treatment. If a ward’s “past or current wishes” conflict with what a guardian feels is best, the guardian “shall have this ethical dilemma submitted to the court for direction,” the rule says.

But Hackney said the rule is only meant to permit a guardian to seek a judge’s guidance “when the course of action is not clear” — not to require it.

“If the Guardian acted under the statute she would be immune from civil or criminal liability for the DNR decision,” the petition said. “There was no legal basis ... to support Judge Thorpe’s ruling that court approval needed to be sought prior to consenting to a DNR Order executed by a physician for the benefit of the Ward.”

In Stryker’s case, an investigation by the Okaloosa County Clerk of Circuit Court and Comptroller found Fierle refused to remove the DNR order despite Stryker’s desire for life-saving actions and against the wishes of his daughter, his health-care surrogate and a psychiatrist.

When asked about the DNR she filed on Stryker, Fierle told Okaloosa Clerk auditor and investigator Andrew Thurman that it was “an issue of quality of life rather than quantity” and Stryker had agreed to it.

“The ward had never previously expressed a desire to die, and it seems unlikely that, as soon as he was appointed a guardian, he would suddenly be unwilling to tolerate a condition that he had been dealing with for many years,” Thurman wrote in his report.

The Ninth Circuit Judicial Court was unable to comment on the appeal, a spokeswoman said.

Full Article & Source:
Guardian at center of Florida scandal appeals judge’s ruling that she broke state rules by misusing DNRs

Death Cafes Spur End-of-Life Care Conversations

by Audrie Roelf

Hospice providers nationwide are seeking and developing strategies for engaging with patients earlier in the course of their illness, as many patients come into hospice too late in the course of their disease to reap the full benefit of those services.

One such strategy is to encourage early conversations about death, dying and associated health care goals and wishes. With this in mind, some organizations are embracing a phenomenon known as death cafes.

The idea of death and dying is one most Americans avoid. Few want to consider the impending death of a loved one, let alone confront their own mortality. Enter the death café, a place where this topic is discussed openly and honestly in a confidential setting with tea and cake.

These events are part of a growing trend among the public in which individuals are working to evolve society’s understanding and perception of death.

“There are pockets of folks who are having conversations about death and end-of-life care much more proactively,” Arul Thangavel, M.D., president of Wisercare, told Hospice News. “These are consumer groups or groups of private individuals who believe that we need to reconceptualize death as something that does not necessarily have to take place in a hospital but can be much more of a soft landing and much less acerbic to family members and everyone involved.”

The first death cafe was held in September 2011 in England by Jon Underwood who developed the idea from the writings of Bernard Crettaz, a Swiss sociologist who posited that discussing death leads to authenticity and combats denial. Lizzy Miles, a hospice social worker from Columbus, Ohio, and death café activist, is credited for bringing the concept to the United States.

“I noticed that any time it comes up in conversation that I’m a hospice social worker, people begin telling me their stories,” she said. “So, when I heard about this concept in England, I figured people have a desire to talk and I thought that in creating this people would become more comfortable talking about death if they weren’t already.”

The concept of the death café is simple: These are casual gatherings held in coffee shops, restaurants, libraries, and senior communities. Hosts are volunteers, usually someone who has a close tie to the subject, such as a social worker, chaplain, or hospice employee who lead a discussion regarding issues surrounding death. There are no sales pitches or organizations to join, and no cost to the participants.

Death cafes are not support groups, rather, discussions between curious participants often center around advance care planning, physician-assisted dying, funeral arrangements, and what happens after death. Facilitators typically move around the room monitoring conversations to identify anyone who might need counseling to pull them aside and tell them where to find help.

“I like to give an introduction regarding the history of the death café and set some ground rules,” Miles told Hospice News. “I start the conversation by asking people to talk about what brought them here and the attendees take it from there. People usually have topics on their minds when they come to these events.”

Miles added that people often share personal experiences, thoughts on final wishes, books they’ve read, and so on.

Kathy Miller, LCPC and owner of Mindfulness Matters in Skokie, Ill., has facilitated death cafes for around five years and said there is no agenda or course of action as a rule, “We want to offer a safe space to talk about death and dying and, by extension, life and living,” she explained. Miller has hosted participants as young as 18 and once had a World War II veteran in a café. Some younger people who are proactive about wanting their final wishes documented may come to a café and make connections.

“Often, we talk about the grieving process and mixed emotions surrounding that,” she said, explaining that in the situation where someone may have been a caregiver during an extended illness, that often includes feelings of release. “Those feelings of release, feelings that they got their life back, cause some guilt and shame. We’re here to talk about that openly and honestly.” She said groups often come to discuss spiritual and philosophical questions as well as how to discuss death and final wishes with loved ones without sounding morbid. Some even discuss feelings surrounding the loss of a pet. “These discussions often can be lively,” Miller noted. “We grieve, cry, and laugh; commonality and humor are often a part of the meeting.”

Miller said that while some come to speak some simply listen. “The group setting is wonderful because people realize they aren’t alone. To hear about the experiences of others helps people realize the connection we have as humans. Grief is not a pathology. It takes its own time and never actually goes away, we just learn to live with it.”

Hospice is sometimes discussed due to lack of knowledge surrounding hospices and what they offer. Miller said it would be beneficial for hospices to offer these discussions themselves, “every hospice and palliative care center could benefit from these cafes…they help people understand the process of death and aid in a healthy grieving process.”

Miles told Hospice News that she once hosted a death café specifically for hospice volunteers. “The volunteers loved it and I received great feedback. They shared stories, gave advice, and supported each other.” She added that medical professionals are often attracted to these events because there isn’t that type of support and conversational environment on the job.

Recognizing the value of these early conversations, hospice providers are taking note of this movement. Some hospice organizations are indeed hosting their own death café, including the Zen Hospice Project in San Francisco and the Hospice of San Luis Obispo, also in California, which holds a death café bimonthly.

Carris Health Rice Hospice in Willmar, Minn., recently began offering a variation on death cafés that focuses specifically on educating the public about hospice care. Dubbed “Hospice Cafés,” these gatherings take place in three local coffee shops.

Notably, the conversation about cultural perceptions of death is taking place not only in death café, but also in the C-suites of companies that provide hospice.

When asked about the forthcoming Medicare Advantage hospice carve-in at the National Association for Home Care & Hospice Financial Management Conference in Chicago, the chief innovation officer of LHC Group (NASDAQ: LHCG), Bruce Greenstein, replied, “Instead of putting our energy into a Medicare Advantage carve-in, we should be focusing our energy on changing the sociology of death so that patients and families can begin receiving hospice care earlier.”

Full Article & Source:
Death Cafes Spur End-of-Life Care Conversations

Tuesday, October 15, 2019

Tonight on Marti Oakley's TS Ratio Network: GRETCHEN RACHEL HAMMOND UPDATES



5:00 pm PST…6:00 pm MST…7:00 pm CST…8:00 pm EST
"Join us this evening as Gretchen Rachel Hammond returns! We have lot to talk about!

We will be discussing the do's and don'ts of survivors of guardianship abuse and, the failure of agencies to act when a crime is reported to them with evidence. It would appear, it is only a crime if someone outside the inner circle does it. If it is one of these tribunal participants like probate examiners, guardians, attorneys and others who routinely traffic the elderly and disabled through these kangaroo courts, nothing will be done. The police won't respond, nor will any agency whose sole existence is supposed to be making sure these things don't happen no matter who does it! Obviously if you are connected to these rackets no one will make a move against you.

Gretchen will also speak about her new position with the National Association to Stop Guardian Abuse (NASGA) where she will head up Community Outreach. After her year long investigation on the massive abuses taking place in Michigan probate tribunals, Gretchen is off on a new endeavor!"

LISTEN TO THE SHOW LIVE or listen to the archive later

Why are nursing homes drugging dementia patients without their consent?


It helps control the residents, and institutions are rarely punished.

By Hannah Flamm

A year and a half ago in a Texas nursing home, I met an 84-year-old resident with dementia named Felipa Natividad. Her sister, Aurora Suarez, told me that the staff dosed Natividad with Haldol, an antipsychotic drug, to ease the burden of bathing her. “They give my sister medication to sedate her on the days of her shower: Monday, Wednesday, Friday,” Suarez said. “They give her so much she sleeps through the lunch hour and supper.” A review of Natividad’s medical chart confirmed the schedule.

Suarez said she had given her consent to use the drugs because she feared that the staff would not bathe her sister enough if she refused. But when Suarez saw the effect they had, she had second thoughts. She expressed them to the nursing home, but Natividad was taken off the antipsychotics only after she was placed in hospice care. She died a few months after my interview. Her family, seeing her in a reduced state and unable to communicate, wondered whether the drugs had compounded the losses associated with dementia; Suarez thought they contributed to her sister’s decline. “She gets no nourishment,” she told me not long before Natividad died.

The use of antipsychotic drugs as chemical restraints — for staff convenience or to “discipline” a resident — has a long history in nursing homes. In 1975, the Senate released a report, “Drugs in Nursing Homes: Misuse, High Costs, and Kickbacks,” documenting some of the same trends we still see, more than 40 years later. In the past decade, many manufacturers of antipsychotic drugs have faced civil and criminal penalties for misbranding the medications to promote them as appropriate for treating older people with dementia. For more than a decade, the Food and Drug Administration has required manufacturers to place the strongest caution, known as a “black box warning,” on the packaging to advise against the medicines’ use in these patients; such drugs almost double the risk of death for them and have never been approved as safe or effective for treating symptoms of dementia. Despite the warning, nursing homes still often administer antipsychotic drugs in this manner, sometimes without seeking informed consent first, in violation of federal regulations and human rights norms.

Last year, I visited more than 100 nursing homes across six states as part of Human Rights Watch research on the abuse of antipsychotic drugs in such facilities. Based on government data, we estimate that in an average week, more than 179,000 older people in nursing homes are given antipsychotic drugs without an appropriate diagnosis. The powerful medications were developed to treat schizophrenia, but staff most commonly administer them to older people with dementia. Too often, nursing homes use the antipsychotics for their sedative effects rather than to treat a medical problem. It’s true that the prevalence of antipsychotic drugs has declined in recent years, from 1 in 4 nursing home residents without an approved diagnosis in 2012 to 1 in 6 today, but that falsely suggests that a longtime wrong is being righted. Government enforcement of regulations prohibiting the use of the drugs as a chemical restraint or without informed consent remains weak. What’s more, two Trump administration decisions threaten the progress made in curbing the abuse.

These powerful drugs are misused for a variety of reasons, including a misperception by nursing home staff that the medications can help people with dementia; a lack of awareness of their dangers, despite the black box warnings; lack of training in dementia care; and, perhaps most significant, to compensate for understaffing. Nursing homes have been exaggerating levels of nursing and caretaking staff for years, according to an analysis of federal data by Kaiser Health News.

To understand the human toll of the misuse of antipsychotics, in my visits to the nursing homes I interviewed more than 300 people — residents, their families, staff, ombudsmen and doctors, as well as researchers and regulators. In most cases, I did not use their names in my report because they cited a fear of retaliation for speaking openly to me. Human Rights Watch did not identify the individual facilities in its report because the abuse is so pervasive in the industry, and not identifying nursing homes persuaded some staffers to speak with me. Further, the goal was not to expose particular private actors so much as to pressure government officials to enforce minimum health and safety standards for all providers.

I found that too often, antipsychotic drugs are administered in harmful, avoidable ways and without the appropriate consent. They are used to control people. Nursing home residents and their family members repeatedly told me they were given these medicines without their knowledge, without awareness of the risks or over their objections. Staff members frankly admitted giving residents these medicines for their own convenience, with some saying they were not aware of an informed-consent policy. Nursing facility staff, pharmacists and medical directors described how doctors commonly prescribed the medications at the request of nursing staff, without even seeing the patients.

Nursing homes turn to antipsychotic drugs — among other classes of psychotropic medications — because dementia is associated with agitation, irritability, aggression, delusions, wandering, disinhibition and anxiety. While such symptoms are frightening for the people experiencing them and challenging for their caregivers, institutional or otherwise, antipsychotic drugs have not been found to be effective at managing them. In a small number of particularly complex cases, antipsychotic drugs may be appropriate as a last resort. But that is a far cry from how they are used. The American Psychiatric Association concludes that the drugs offer “at best small” potential benefits (such as minimizing the risk of self-harm in people with extreme agitation), while “on the whole, there is consistent evidence that antipsychotics are associated with clinically significant adverse effects, including mortality.”

On paper, federal regulations say that residents have the right to be fully informed of their treatment and to refuse treatment, which should amount to a right to informed consent. But nursing facilities widely ignore the rules, partly because they are rarely held accountable. Reviewing government data from 2014 through mid-2017, Human Rights Watch found that in 97 percent of citations for violations related to antipsychotic drugs, the incidents were determined to have caused “no actual harm” to residents. As a result, in almost no cases did the government impose financial penalties, which correspond to the severity of harm caused by the noncompliance. The prospect of enforcement actions, and the rare sanctions issued, unsurprisingly had little deterrent effect, our analysis found. Nursing homes cited for antipsychotic-drug-related issues did not reduce their rates of drug use any more than facilities not cited.

The way nursing homes obtain or define “informed consent” can also be a factor in the drugs’ misuse. “The use of specific medicines, particularly for somebody with dementia, who lacks the capacity to consent themselves, should require informed consent from their legal representative,” says Jonathan Evans, a former president of the American Medical Directors Association. “But in practice that seldom happens. Not just for that medicine but for any medicine.”

The former administrator of a nursing home in Kansas, who asked to remain anonymous, said: “The facility usually gets informed consent like this: They call you up. They say: ‘X, Y and Z is happening with your mom. This is going to help her.’ Black box warning? It’s best just not to read that. The risks? They gloss over them. They say, ‘That only happens once in a while, and we’ll look for problems.’ We sell it. And, by the way, we already started them on it.”

Despite the limited threat of penalties, many nursing homes have reduced inappropriate use of the drugs in recent years anyway, in response to increased public pressure. By 2012, congressional outrage over the widespread misuse of medications, costing hundreds of millions of Medicare dollars annually, had motivated the Centers for Medicare and Medicaid Services (CMS) to create the National Partnership to Improve Dementia Care in Nursing Homes . While the partnership is only a voluntary initiative offering educational support to train providers, the increased attention has been associated with the reduction in misuse. But it is hard to celebrate the decline when the government elects not to rigorously use the tools it has to protect Americans in nursing homes from irreversible harm.

What’s more, the national reduction may be misleading — and it may not last. First, there’s been a notable uptick in the diagnosis of schizophrenia (a disease that typically develops before age 30) in predominantly elderly nursing home populations. This increase corresponds to the rising pressure on facilities to reduce off-label antipsychotic drug use. There’s no proven link, but the trend does suggest that some homes seek false diagnoses to avoid red flags with the use of these medications. A second concern, recognized by CMS, is that nursing homes are simply replacing this closely watched class of psychotropic medication with other types of sedating drugs with similar health risks.

Meanwhile, in response to an industry request, the Trump administration in July 2017 changed its guidance on financial penalties, limiting the instances when inspectors can assess the heaviest fines. The guidance also favors one-time sanctions for harmful noncompliance with the law, rather than a per-day sanction that corresponds to the number of days the harm persists. As a result, in many cases facilities face less-significant consequences for harming residents than they used to. And last November , CMS imposed an 18-month moratorium on Obama-era revisions to some regulations — not updated since 1991 — intended in part to protect residents whose psychotropic medications are prescribed on an “as needed” basis. While it is unclear if those new protections will come into force, it is abundantly clear that this administration’s deregulatory scheme, which it calls “Patients Over Paperwork,” reduces oversight and enforcement in an already dangerously underpoliced industry.

Karla Benkula, daughter of a 75-year-old woman in Kansas, said that when the nursing facility began giving her mother an antipsychotic drug, her mother “would just sit there like this. No personality. Just a zombie.” Laurel Cline, the daughter of an 88-year-old woman in a California nursing home, said she thought the facility used antipsychotic medication to silence people whose symptoms disturbed the staff. Cline said it was obvious that her mother had physiological conditions requiring medical attention. “She would be sitting there, slumped over, mucus everywhere. I would go over and say, ‘She’s sick.’ ” But Cline’s mother wasn’t able to advocate for herself, and Cline had to intervene to demand appropriate medical care for a urinary tract infection, pneumonia and a pulmonary embolism, she said.

“Dementia’s already so hard,” said Ashley Plummer, a licensed practical nurse who works in a Kansas nursing home. “But on top of that, throw [on] a few Seroquels [a common antipsychotic drug], and then you’re just drooling. I mean, it’s taking away even your right to be upset about your disease process. It’s taking away your right to mourn what you’re going through.”

In my interviews, it was disturbing how frequently staff justified administering antipsychotic drugs for “behaviors,” a disconcerting term suggesting that residents could, and should, avoid acting in a disruptive way. A social worker in Texas who used to work in a nursing facility said the underlying issue is that “the nursing homes don’t want behaviors. They want docile.”

Many nursing home staff spoke to me about using antipsychotics to control residents as if it were a perfectly acceptable practice. Others told me that they had become aware that antipsychotic drugs were frequently misused only after the facility’s administration or corporate owners decided to cut down on their use. “It used to be like a death prison here,” a nursing director in a Kansas nursing home told me. “Half our residents were on antipsychotics. Only 10 percent of our residents have a mental illness.” Senior staff at the facility led an effort to reduce the antipsychotic drug rate after receiving financial penalties for administering unnecessary medications and after pressure from the chain’s owners. Another nurse in Kansas said: “We were at 55 percent antipsychotic drug rate before. Now we’re down to only people with a diagnosis [for which the FDA has approved the medications] on the drugs. They have a better quality of life because they’re not sedated.”

Nursing homes, a mostly for-profit industry, control most aspects of their residents’ lives. Presumably, providers would be more inclined to meet minimum health and safety standards if it cost them dearly not to do so. “In this industry, there is a real cost-benefit analysis,” one long-term-care consultant told me. “If the fine will be $100,000, then they’ll hire the three nurse aides who will cost them about the same amount.”

Antipsychotic drugs may be an appropriate treatment for some people with dementia in nursing homes, but determining that requires a doctor and an informed patient (or proxy). And once told of the significant risks, unlikely benefits and possible alternative treatments — such as behavioral therapy, adjusting routine and environment, or alleviating the source of underlying loneliness, pain, boredom or fear — many people would probably reject the drugs. As one long-term-care pharmacist in Kansas said: “I don’t think antipsychotic drugs are presented well to the family in informed-consent conversations. Because if it were, they’d all reject it.”

An 81-year-old man in a Texas nursing home put it this way to me: “Too many times I’m given too many pills. I can’t even talk. I have a thick tongue when they do that. I ask them not to [give me the antipsychotic drugs]. When I say that, they threaten to remove me from the home. They get me so I can’t think. I don’t want anything to make me change the person I am.”

Full Article & Source:
Why are nursing homes drugging dementia patients without their consent?

Easton lawyer accused of draining estate, buying Super Bowl tickets with clients’ money

An Easton lawyer is charged with stealing more than $400,000 from the estate of a New Jersey man whose children hired him to put their father’s affairs in order.

In addition to depositing money from the estate into his personal and law firm checking accounts, federal prosecutors allege attorney Angelo Perrucci Jr. used the dead man’s money to treat himself to tickets for the Eagles 2018 Super Bowl appearance in Minneapolis.

Perrucci, 55, who lives in Bangor but has a law office on Walnut Street in Easton, is charged with five counts of wire fraud for allegedly issuing and depositing fraudulent checks and misleading the victim’s children.

“Attorneys of any kind, public or private, take an oath to act in accordance with the law — not to use their law license to steal. My office will continue to root out the type of conduct that is alleged here,” U.S. Attorney William McSwain said in a statement.

Court records do not list an attorney for Perrucci. A telephone number listed for Perrucci was disconnected and he did not immediately respond to a message left at his law office.

According to an indictment charging Perrucci, the children of the dead man, who is identified only by the initials P.D., retained Perrucci in 2015 to put together their father’s estate, including selling his properties and disbursing the money to his heirs. Perrucci agreed to charge his clients $300 an hour or a maximum of $7,500, which they had already paid as a retainer.

P.D. died without a will in January 2016 in New Jersey, where he lived. Perrucci was appointed the administrator of P.D.’s estate, the indictment says.

According to the indictment, between April 2016 and January, Perrucci deposited money into an estate account from P.D.’s checking, investment and insurance accounts and overseas bank accounts. From the estate account, he wrote more than 80 checks that he deposited into his law firm’s operating account, payroll account and his personal bank accounts, prosecutors allege.

In February, Perrucci told P.D.’s children in a telephone call that he estimated he had taken $30,000 from the estate and expected to take an additional $30,000. At the time, Perrucci had taken about $344,250, the indictment says. In the phone call, he also promised P.D.’s children that he would notify them before taking any more money, but actually wrote another seven checks totaling $42,000 without notifying his clients, the indictment says.

During a second phone call with P.D.’s children in April, he agreed to provide a bank statement for the estate account and an accounting of the money he had taken and disbursed on behalf of the estate. P.D.’s children never received the bank statement, the indictment says.

Also during the April phone call, Perrucci told P.D.’s children that money from the sale of P.D.’s home at the Jersey shore were being held in a trust account and could not be released, when he had allegedly transferred some of the money into the estate account and taken $32,500 for himself.

The indictment says that although Perrucci was the administrator of P.D.'s estate for more than three years, he never sold P.D.’s primary residence and failed to collect nearly $100,000 from an investment account.

If convicted, Perrucci faces a maximum possible sentence of 100 years in prison. The case was investigated by the U.S. Postal Inspection Service, and is being prosecuted by Assistant U.S. Attorney Christopher J. Mannion.

Full Article & Source:
Easton lawyer accused of draining estate, buying Super Bowl tickets with clients’ money

Parkland Man Arrested for Bilking Elderly in Money Laundering Scheme

Isaac Grossman
By: Saraana Jamraj

A Parkland man has been arrested and accused of orchestrating a sizeable money-laundering scheme that involved defrauding elderly victims with promises of quadrupling their money.

In a joint effort between the Federal Bureau of Investigations, the Security and Exchange Committee, and the U.S. Attorney’s office, Heron Bay resident, Isaac Grossman, 45, was investigated and indicted on the charges of wire fraud, mail fraud, and money laundering.

Grossman ran a company called Dragon-Click Corp, a South Florida-based technology company, which he allegedly used to target the elderly to pull off an array of financial crimes.

According to the indictment by U.S. Attorney Ariana Fajardo Orshan and George L. Piro, Special Agent in Charge of the FBI’s Miami Field Office,  Grossman spent at least $1.3 million of investors’ money on gambling, diamond jewelry, luxury cars, tuition payments for his children’s private education, and other personal expenditures.

Some of the larger purchases made include $35,000 of investors’ funds on a 4.81-carat diamond ring, $21,200 for a lease payment on a McLaren MP4-12C, $36,500 to purchase a Chevrolet Corvette, and $34,500 to partially pay off his home mortgage.

In the alleged scheme, Grossman sought elderly retired investors across the country to invest in his business. To attract potential investors, he told them about a revolutionary new shopping app that would allow users to post a photo of any item they might want to purchase, and immediately recognize all retailers who also sell the item, as well as provide price comparisons and links to purchase.

The product he described bares some similarity to Google Lens, an existing app that can contextualize photos users submit, providing them with identification information about it.
To further solicit them, Grossman allegedly told investors that his company would be sold to larger corporations, such as Google, Apple, or Amazon, for more than one billion dollars and that their money could even be quadrupled. 

From September 2014 to April 2018, with at least 26 investors, Grossman was able to raise approximately $2.4 million.

Isaac and his wife, Adriana Grossman.
Instead of using the money for an internet application, patent, legal fees to close that supposed billion dollar sale, or any other legitimate business purposes, Grossman allegedly used that money to provide and maintain a lavish, luxurious lifestyle for him and his wife, Adriana.

This was not Grossman’s first brush with the law.  After entering the financial securities sector in 1997, he faced regulatory reprimand and consequences in 2012.

In addition to misusing investors’ money, Grossman also fraudulently concealed this fact from investors that he was permanently banned from acting as a broker by the Financial Industry Regulatory Authority and banned from trading the U.S. Commodity Futures Trading Commission. He also owed them over $121,000 fines.

Grossman and his wife were also hit with a civil lawsuit by the SEC in June of 2018, where their financial crimes were further detailed, including an alleged $426,000 of investors’ funds used solely on gambling. Adriana was alleged to have spent at least $293,000 of investors’ money between 2014 and 2016.  Their LLC, Dragon Management, was organized by her, and she was listed as the sole signor, likely so they could do business under her name.

Isaac Grossman was arrested on October 11 and faces a minimum of 20 years for each fraud charge, and 10 years for each money laundering charge.

Full Article & Source:
Parkland Man Arrested for Bilking Elderly in Money Laundering Scheme

Monday, October 14, 2019

The New Face of Homelessness: Elderly and Disabled

The story of three brothers evicted from their family home show the difficulties this population faces in the East Bay.

by Jade Yamazaki Stewart

William & Darryl Patrick are living on the street in front of their former home.
The Patrick brothers lived in their family home on Berkeley's Evelyn Avenue for most of their lives. Their parents bought the house in 1953, before the brothers were even born. They played Little League at a local elementary school, and attended Berkeley High. But Darryl and William struggled with mental disabilities and could not live on their own. Meanwhile, Frederick began suffering from congestive heart failure in his forties, which made it hard for him to live independently. In 2015, all three brothers were living with their mother. But then she died — and the family began fighting over her estate.

Now the brothers, all of whom are around 60 years old, live in a recreational vehicle on the street in front of their old home. In August, Berkeley police evicted William and Darryl from the house and nearly arrested them for trespassing. They were living there illegally after an earlier May eviction ordered by their brother-in-law, who ended up managing the property.

"We'd been living in the house our whole lives," William said recently. "We're really irate about getting kicked out of our home."

Plywood boards now cover the windows of their vacant house, which the brothers still partly own. The locks have been changed so that they cannot enter. A green plastic wreath decorated with red ornaments still hangs above the home's doorway from last Christmas.

Neighbors managed to convince the police to let the Patricks stay in the RV. But the motor home is badly insulated and doesn't have a functioning bathroom or kitchen, and the brothers are regularly awakened at night by cars speeding by.

Many elderly people become homeless under similar situations. "Disabled adults often become homeless when their caretakers pass away," said Elaine de Coligny, executive director of the homeless advocacy group EveryOne Home.

Disabled homeless people are extremely common in the Bay Area and less likely to find new housing than other homeless people. And elderly or disabled people suffer more serious health consequences from living in the street than their younger, healthier counterparts.

EveryOne Home estimates that 42 percent of the 8,000 people who are homeless at any given time in Alameda County have a disability. The numbers are even higher in Berkeley, which is a mecca for the disabled due to its role in the birth of the disability-rights movement. Some 68 percent of the 2,000 people who annually experience homelessness in Berkeley are disabled, according to a city report. Analysis conducted for the report concluded that having a disability of any kind increased the likelihood that someone would remain homeless by 733 percent.

People over the age of 50 already make up around half of homeless in the United States, according to Dr. Margot Kushel, a professor of medicine and director of UCSF's Center for Vulnerable Populations. And the percentage of homeless people over 50 is projected to keep rising until 2030, with the homeless population older than 65 expected to triple.

Kushel has conducted research following 350 people over the age of 50 who were homeless in Oakland in 2015. Nearly half had never been homeless before they reached that age. Unlike younger people, whose homelessness is normally tied to a long history of issues, Kushel found that people who started living in the streets later in life could often trace their homelessness to a single event. Common causes of homelessness included losing a job, having a family member or roommate lose a job, or having a family member die. Many became homeless after an elderly parent's death led to them being forced out of their family homes. Family disputes over estates were often involved.

Because seniors like the Patricks often receive fixed retirement incomes that do not increase along with rising housing prices, many people who become homeless after age 50 cannot afford new places to live, noted Leslie Gleason, director of programs for Shelter Inc., a group that fights to end homelessness in the Bay Area.

When the Patrick's mother died, she was survived by Darryl, William, Frederick, and their sister, Annette Olsen. Carmel Patrick died without a will, so Annette successfully petitioned to become her administrator in June 2017. Then Annette died in April 2018, and her husband, Michael Olsen, succeeded her as administrator. Frederick unsuccessfully objected in court to both administrations.
In April 2019, Michael hired lawyer Richard Palenchar and sought to evict the brothers from the house. A lawyer representing the brothers without pay objected on their behalf. "Defendants Patrick are senior citizens and not in good health," Elaine Videa wrote. "Evicting them out of their home would cause severe hardship, further injuring their health, and cause severe emotional distress." But the court ordered the brothers to vacate the property by May 14.

Frederick was in the hospital at the time, but William, Darryl, and their terrier Honey Bear started living in a Ford SUV in front of the house. Then they drove the car to Ukiah and lived in it for a couple of weeks in June. But William drove off the side of the freeway one night, totaling the car and landing himself and Darryl in a hospital. Honey Bear wound up in a dog pound. Darryl returned to Evelyn Avenue and started living there illegally, but William spent a month in an assisted-living facility in Sacramento. When Frederick was released from the hospital, he and Darryl immediately drove to Ukiah to retrieve Honey Bear from the pound.

By the time of the second eviction, Frederick was back in the hospital being treated for symptoms of his congestive heart failure. Following his Sep. 6 release, he joined his brothers in the RV, where they have now been living with Honey Bear for around a month.

"I just don't know how long we're going to be out here in this thing," William said.

The brothers' disabilities, like those of thousands of other homeless people in Alameda County, make their lives especially difficult. William was born premature and oxygen-deprived. Their father, who had head injuries from World War II, punched William in the left eye when he was nine or 10, according to a letter from the Social Security Administration. The following year, a neighborhood bully hit William in the side of the head with a rock, causing injury and trauma. Their father also shook Darryl when he was an infant, causing brain damage, according to Frederick. Darryl is also diabetic.

Frederick has been suffering from congestive heart failure for 20 years. This causes edema, accumulations of liquid in his legs. His calves are swollen, purple, and have holes in them where his skin has burst from the pressure. Liquid oozes out of the holes, and he has to change his bandages every day. This is difficult in the cramped space of the RV.

None of the brothers have money right now, and their mother's estate consists solely of the house, which hasn't been sold. So concerned neighbors like their former next-door neighbor Douglas Walters have been helping the Patricks by bringing them meals and other necessities. Walters keeps a cooler in the RV stocked full of ice for storing food. He gave the brothers a water tank so that they could take sponge baths and do dishes.

"These were guys that I was going to see laid out on the street in fairly short order," said Walters, who has lived next to the Patricks for 23 years, and used to chat with their mother over the fence. "I didn't think it was anything they deserved by any means."

He worries that Darryl and William's stint in Ukiah shows what might happen to them without help.

Meanwhile, neighbor Andrea Henson brought the brothers' case to Osha Neumann, a lawyer with the East Bay Community Law Center who specializes in homelessness. Neumann and Henson have been working to find an assisted living situation for the Patricks, but haven't had any luck.

Elderly and disabled homeless people often can't live independently and need assisted living situations, which are becoming scarce and expensive in the Bay Area. Between January 2016 to August 2019, dozens of residential care facilities for the elderly closed in Alameda County, according to Dr. Robert Ratner, the housing services director at the Alameda County Health Care Services Agency. The remaining facilities normally cost more than $4,000 per person per month to stay in, Ratner said.

Such facilities have all but disappeared in the Bay Area, Kushel said, because rising housing prices have made them economically unfeasable. The brothers said that when they looked into finding board and care houses to stay in, they were told that the only one available was in Sacramento, and that the wait period for entry was three to five years.

That long being on the street could kill an elderly person in poor health. "The very experience of being homeless makes chronic health conditions worse because it makes it hard to get prescriptions, go to the doctor and get to appointments," Shelter Inc.'s Gleason said.

Neighbors have called various social service organizations, so far to no avail. Despite the brothers' obvious health issues, Adult Protective Services evidently doesn't consider them dependent adults because they don't have enough documented physical and mental disabilities to qualify.
As a mother of a 24-year-old with mental disabilities, Gleason is worried about what will happen when she dies and her son is left on his own.

"We see what's happening to 60 and 70 year olds now, and we're afraid," Gleason said. "We're scared to death about what's going to happen to our kids."

In spite of it all, the brothers are luckier than most homelwess people in the East Bay because they have support from friends, Neumann said.

"Imagine how hard it would be for a homeless person without a phone, a computer or a permanent address to get the help they need," he said. "Know that the difficulties we are facing in trying to help the brothers are the same difficulties that homeless people face across the Bay Area and across the country."

Full Article & Source:
The New Face of Homelessness: Elderly and Disabled