Are These Cases of Loving Families or Elder Abuse?

by David Hochman

William J. Hennessy Jr.

A generous kin or addled aunt?

The situation: For more than 30 years, 84-year-old Genyte Dirse owned and operated a small beachside motel next door to the triplex apartments she owned in St. Pete Beach, Florida. Gedi, her great-nephew, had lived with her temporarily after coming to the U.S. 15 years earlier, at age 20, from their native Lithuania. In December 2017, Genyte sold one of the triplex buildings to Gedi for $50,000 — a fraction of its $250,000 market value. Real estate agent Diana Sames called foul. She said that Genyte's faculties were failing and that the great-nephew exploited his aunt during the sale.

The case: Sames petitioned a judge to put Genyte under the control of a guardian, testifying that Genyte was not thinking clearly. Gedi countered that the agent had showed little interest in his great-aunt until the property was transferred to his name. As for Genyte's capabilities, Gedi and tenants said she was doing just fine on her own and still managing to run the motel; Gedi was helping drive her to the grocery store, church and doctor appointments.

Real love or elder abuse?

The situation: In the fall of 2015, an octogenarian gentleman from Virginia (let’s call him G.K.) met a much younger woman (M.C.) and, soon enough, they were married. The groom doted on M.C. and began lavishing gifts upon her — a late-model Jaguar, real estate, thousands of dollars to pay off M.C.’s bills. But there was trouble in paradise. Within a year, it became clear that M.C. was funneling some of the riches to a boyfriend.

The case: G.K. clearly trusted and felt great fondness for his new bride. The court documents show that he cosigned a loan application and made a $2,500 down payment on M.C.’s fancy car. He also obtained a $50,000 mortgage to help erase M.C.’s debts. To pay off his mounting bills, G.K. took out another $105,000 loan a month later. G.K., by all appearances, was putting his money where his heart was. But the feds saw a sham marriage that exploited an aging man’s diminished mental capacity, and they went after the behind-the-scenes boyfriend for mail fraud and forfeiture of any property or goods derived illicitly.

How to Combat Elder Abuse

Putting an end to elder abuse starts with recognizing the problem. If you believe you or a loved one is the victim of a scam, fraud, neglect, exploitation or other abuse, here’s what to do:

Take notice

Most crimes against older Americans involve someone the victim trusts, family members included. So stay vigilant even when all seems normal. Be involved and engaged with your finances, and stay alert to unauthorized ATM withdrawals, financial requests from ingratiating outsiders or anything that feels unsafe, uninvited or ethically questionable.

Slow down

A classic scam begins with someone rushing you. Nothing is urgent. If anyone claiming to be a law enforcement officer calls to demand immediate payment for failure to show up for jury duty, for instance, hang up and take the time to verify and do research. You can always call back on an official number.

Think twice

Services offered through cold calls or door-knocking solicitors are often fraudulent. If it sounds too good to be true, it’s almost always a scam.

Say something

Ten percent of Americans age 60-plus are victims of elder abuse or fraud. If you’ve been hurt, scammed or exploited, you’re in the company of millions. Try to let go of the shame, self-blame and fear of retaliation, and notify local or federal authorities. The Elder Justice Initiative (justice.gov/ElderJustice) shows you how to find help in your area or report abuse.

Web resources

The National Center on Elder Abuse (ncea.acl.gov) offers links to many resources and describes common scenarios. Get help in your area from adult protective services. Additional information is available through the National Clearinghouse on Abuse in Later Life (ncall.us). If you or someone you know is experiencing domestic violence, go to the National Network to End Domestic Violence website (nnedv.org) to find information and learn about resources. Finally, for more on scams and how to avoid getting caught up in one, go to aarp.org/FraudWatchNetwork.

Full Article & Source:
Are These Cases of Loving Families or Elder Abuse?

See Also:
GoFundMe fundraiser to raise legal fees to free Genyte Dirse

State seeks 7-year sentence for lawyer accused of stealing from clients

Anita Volpe Courier-Gazette file photo

By Stephen Betts

ROCKLAND — The state is recommending that a former longtime Rockland lawyer serve seven years in prison if convicted of stealing nearly $1.2 million from three elderly, incapacitated people.

The recommendations were filed Oct. 7 in the Knox County court by the Maine Attorney General’s Office in preparation for a conference that was held Thursday in the case against 74-year-old Anita M. Volpe of Tenants Harbor.

No settlement was reached Thursday and another dispositional conference is expected in January.

Volpe was indicted in March on three counts of felony theft, two counts of Class B misuse of entrusted property and one count of Class C misuse of entrusted property.

She pleaded not guilty at her April arraignment.

Volpe is free on bail with the condition that she not be a trustee, personal representative or handle finances for anyone  until the case is concluded.

The memorandum filed Oct. 7 by Assistant Attorney General Leanne Robbin alleges that Volpe stole $553,225 from Mary Webb; $490,416 from Patricia Wakefield; and more than $100,000 from Corine Hendrick. The state is proposing that Volpe pay restitution of those amounts to Webb and Wakefield’s estates.

Volpe served as the power of attorney for the three women.

According to the state, Volpe stole from Webb and Wakefield to repay the estate of Hendrick, who was her mother-in-law.

The longtime local lawyer is alleged to have used the stolen money to pay personal credit card debt, and to purchases real estate, according to the state’s memo to the court. The real estate included a parcel abutting her home in St. George.

Volpe also used some of the money to repair her Main Street law office in Rockland, according to the state. And she also is alleged to have used the money to repair her home.

Volpe also traded in a car owned by Wakefield to help pay for a pick-up truck.

A telephone message was left Friday morning with Volpe’s attorney Leonard Sharon of Auburn. There was no immediate response.

Hendrick died Dec. 20, 2014, at age 92, after several weeks in a nursing facility in Augusta that her grandchildren said was very low-quality. The family had wanted to put her in a Camden nursing home, but could not because of a lack of funds.

Volpe eventually issued a check for $119,658 to Hendrick’s estate. The deputy counsel for the Maine Board of Overseers, Aria Eee, however, voiced concern in an April 2016 court filing about where Volpe got the money to pay the estate.

“As such, the Board is concerned that Attorney Volpe likely utilized other client funds in her trust account to issue the $119,658.54 check she paid to Ms. Hendrick’s estate,” the deputy bar counsel wrote in the document.

The Maine Board of Overseers would not comment in 2016 on whether it had referred the complaint to the Maine Attorney General’s Office for a criminal investigation.

The Maine Supreme Court accepted the surrender of Volpe’s license in lieu of disciplinary action in August 2016. Justice Andrew Mead impounded all the documents related to the matter, but Hendrick’s grandson, Shane Hendrick, of Camden, released the paperwork later that year.

Volpe had initially been the personal representative for Hendrick’s estate after Hendrick died, but withdrew before the estate was probated.

In 2016, Volpe’s attorney at the time, Toby Dilworth of Portland, said the allegations against her in the Hendrick case were just that – allegations. “They are not facts. Ms. Volpe was prepared to defend against them. However, given that she was planning to wind down her practice after almost 39 years as a lawyer, she decided to surrender her license rather than engage further in this intra-family dispute,” Dilworth said.

Wakefield was a retired lieutenant colonel in the Army. The state alleges that Volpe stole from Wakefield and her estate from May 20, 2014, through April 2, 2018.

Wakefield died Nov. 11, 2016, at the Knox Center in Rockland at age 87.

Volpe was the personal representative who oversaw the handling of Wakefield’s estate. Wakefield, who had lived in Tenants Harbor before going to the nursing home, had signed the will naming Volpe as personal representative Dec. 15, 2000. Volpe was also listed as having the power to make medical decisions for Wakefield if she was unable to make those choices for herself, according to probate court records.

Wakefield was not married and had no children. Her will left all her assets to the Bolles School in Jacksonville, Fla.

After her death, the Knox Center made a claim against Wakefield’s estate for $49,667.

Volpe, acting as personal representative, oversaw the sale of Wakefield’s house in January 2017.

In regard to the third victim, the indictment against Volpe alleges she stole money from Webb from April 21, 2014, through Jan. 9, 2017.

Volpe was also listed as the durable financial power of attorney for Webb in a probate case involving the disposition of the estate of Webb’s husband, Richard Webb Jr. Richard Webb, a St. George resident, died Jan. 27, 2014, at the age of 86 at the Cushing Homestead.

His obituary listed no children for the couple.

That estate went through a lengthy court battle after allegations that another individual had used undue influence on Richard Webb to have him unknowingly sign a document giving 25 percent of his estate – worth an estimated $2 million – to that individual.

That individual was not Volpe.

The case was eventually settled in June 2016 with the other individual repaying Mary Webb an unspecified amount of money. Webb died in March.

Volpe received her law degree from Widener University in Chester, Pa., in 1975. She was admitted to the Maine Bar in 1977. She practiced in Rockland until she surrendered her license in August 2016.

Full Article & Source:
State seeks 7-year sentence for lawyer accused of stealing from clients

Newton woman sentenced to eight years in prison for elderly abuse

Maciha LaQeish Lewis

A Newton woman has been sentenced to serve eight years in state prison after pleading guilty to one count of financial exploitation of the elderly.

Maciha LaQeish Lewis, 25, was charged with stealing more than $25,000 from a retired educator.

Lewis recently requested alternative sentencing to include community service and/or probation. However, Dale County Judge Kimberly Clark denied the request and sentence Lewis to serve time in the state penitentiary, said Dale County District Attorney Kirke Adams, who said the case was the worst scam used to victimize the elderly he has seen.

“Ms. Lewis approached a retired educator who was working with Wallace Community College,” Adams said. “Ms. Lewis over time approached the victim requesting assistance for emergencies, and so-called needed items. She even convinced the victim to obtain several payday loans. It was also determined Ms. Lewis, a family member with multiple children, approached the victim requesting the victim take out a second mortgage on her home to help Ms. Lewis.”

According to Adams, during the investigation it was determined Lewis tried to pay the victim back with bad checks, and after that scam fell through, Lewis had family members pose as representatives with a family service center.

“The so-called representatives with the family service center informed the victim they would stand good to repay all Ms. Lewis’ debts,” Adams said. “If the victims’ bank had not contacted the victim’s nephew, there is no telling when this crime would have ceased.”

Adams reminds all family and friends of the elderly to keep an eye out for their best interests.

“We have to watch over our elderly friends and family members,” Adams said. “We are seeing more and more widows, widowers, and single elderly victims become targets of financial exploitation,” Adams said. “If you believe a family member or a friend is a victim of financial exploitation, call your local Department of Human Resources or your local law enforcement agency. Help protect our elderly residents.”

Full Article & Source:
Newton woman sentenced to eight years in prison for elderly abuse

TONITE ON MARTI OAKLEY'S TS RADIO NETWORK: Malignant Heroes and Wannabee Celebrities

7:00 CST

Back from her latest wedding cake creations, Coz lights up the show with her views on what she likes to call "malignant heroes". You know these people. Constantly laying claim to other people's hard work and re-inventing themselves as they get outed for their false persona's and credentials. Always morphing and expanding their supposed importance, they appear uninvited to social events, inserting themselves where they are not wanted.

Their claim to fame is a creation of their own making. The damage they do to the efforts of hard working advocates and activists is disheartening at times. Learn to avoid these self proclaimed heroes. This and more news on stories we are following. Callers are welcome or you can message us on Facebook with your comments or questions.

LISTEN LIVE or listen to the show later

Ex-guardian Rebecca Fierle charged Altamonte Springs facility $100K, illegally pocketed refunds, investigation finds

By Monivette Cordeiro and Jeff Weiner

Former Orlando guardian Rebecca Fierle improperly billed an Altamonte Springs assisted living facility almost $100,000 to provide services to their vulnerable patients and pocketed refunds the facility issued to her incapacitated clients, according to a newly released state investigation.

After confronting Fierle about her “excessive" invoices, the facility ultimately told her to find other “places for her wards to reside," according to the investigation.

It’s the second time the disgraced guardian has been accused of illegally profiting from her work handling the affairs of vulnerable adults in financial arrangements not approved by a court. An audit by Orange County Comptroller Phil Diamond’s office found Fierle billed AdventHealth nearly $4 million for services she provided to the hospital’s patients, often double billing those patients for the same service.

Fierle is not currently facing charges, but is under criminal investigation by the Florida Department of Law Enforcement and other agencies after one of her wards, 75-year-old Steven Stryker, died at a Tampa hospital because staff were unable to perform life-saving measures due to a “do not resuscitate” order the guardian filed against his wishes and refused to remove.

Fierle’s work with the Altamonte Springs facility has also been referred to the FDLE for criminal investigation, according to a report obtained Thursday by the Orlando Sentinel.

“We referred this case to the Florida Department of Law Enforcement (FDLE) because we determined there was probable cause to allege that criminal activity occurred,” wrote Andrew Thurman, an auditor and investigator with the Okaloosa County Clerk of Courts and Comptroller.

Thurman was not able to interview Fierle. Neither she nor her attorneys responded immediately to an immediate request for comment.

The former executive director of that facility, the name of which was redacted from the report, told Thurman that he was initially “relieved” when Fierle was appointed guardian for some of its patients, who had racked up significant medical bills they could not pay.

The ex-director said he hoped Fierle could get the wards signed up for benefits and start paying their outstanding bills.

Instead, he said, Fierle started sending the facility bills of her own.

Between 2008 to 2015, the facility paid Fierle about $99,000 for her services to 16 residents at the facility, six of whom were her court-appointed wards in Seminole County. The guardian charged the facility for work related to petitioning the court for guardianship, as well as guardian fees, which are typically charged to a ward’s existing assets.

The investigation determined Fierle never reported or disclosed the payments she was getting from the facility to the court — a violation of state law.

“Because the funds Fierle received ... were not approved by the court or shown on the annual accounting, they represent an undisclosed indirect financial interest in the guardianship,” Thurman wrote.

In late 2016, facility staff held a meeting with Fierle where they questioned the guardian about her billing practices and told Fierle her invoices “seemed to be excessive.” They also confronted her about her wards’ outstanding medical bills, the report said.

When staff did not find Fierle’s responses “sufficient,” they asked the guardian to move her clients out and not place any more of her clients at their facility.

The investigation began in response to an anonymous Oct. 31, 2017, complaint to the state’s Office of Public and Professional Guardians alleging Fierle was receiving direct payments from the facility. OPPG, which has faced a firestorm of criticism for its handling of grievances against guardians, sent the complaint to the Okaloosa Clerk’s office on April 2 — 17 months after the complaint was submitted — to investigate.

As Thurman was interviewing the facility’s staff, the current executive director gave him copies of checks the facility gave Fierle related to refunds owed to her incapacitated patients.

The director told Thurman that, when a ward left the facility or died, the facility would issue a check to Fierle for any overpayments or petty cash the facility was holding for the wards to use. Thurman noted that, while payments for guardianship services were made out to Fierle’s company, Geriatric Management, the refund checks were made payable to Fierle — directly.

Thurman found no evidence Fierle returned that money to the ward’s estate after analyzing annual accountings the guardian filed with the court, according to the report.

Full Article & Source:
Ex-guardian Rebecca Fierle charged Altamonte Springs facility $100K, illegally pocketed refunds, investigation finds 

See Also:
Florida Elder Affairs chief announces ‘immediate’ changes as embattled Orlando guardian Rebecca Fierle resigns from all cases

Florida professional guardian Rebecca Fierle: Devoted or dangerous? | Exclusive

Cremated remains of 9 people found at Orlando office of disgraced former guardian Rebecca Fierle

Expert’s complaint against Florida guardian Rebecca Fierle was ignored for years before scandal erupted | Exclusive

Orlando guardian accused of filing unauthorized ‘do not resuscitate’ orders resigns from Seminole cases

Watchdog: In Short Hearing, Fierle Given Guardianship Over Patient

Judge releases confidential information to authorities investigating former Orlando guardian Rebecca Fierle

Judge looks to make changes guardianship program following Fierle case

Click to Watch Video Report

Greg Fox, Reporter

ORANGE COUNTY, Fla. — WESH 2 Investigates has learned of changes aimed at keeping a closer eye on public and professional guardians.

Guardians are those appointed by a court to handle the medical and financial affairs of incapacitated, mostly elderly, people.

A criminal investigation was launched after a ward of former professional guardian Rebecca Fierle, Steven Stryker, died just days after Fierle refused to revoke a do-not-resuscitate order.

Officials said Fierle signed the order without the knowledge of Stryker or his daughter, Kim Stryker.

"I would like to see justice for my father," she said.

The investigation prompted Central Florida courts to revoke more than 140 other DNRs for her wards, including Jack Meagher.

"Somebody needs to try to save my life," Meagher told WESH 2 News.

Last month, Orange County's Comptroller released an audit that said Fierle had billed AdventHealth more than $3.6 million during the past five years, mostly for unknown services for 472 patients who were not legally her wards.

The audit also found she double-billed AdventHealth and some of the 95 patients who were listed as wards.

Donald Myers, the chief judge of the 9th Circuit, which includes Orange and Osceola counties, is making changes to the way guardian cases are handled to ensure vulnerable, mostly elderly people, are not victimized by their guardians.

"Through the Rebecca Fierle story and incident we have recognized that there are parts of the guardianship system that we just do not have the resources to address," Myers said.

Myers told WESH 2 News he's changing that.

A new judge will be added beginning Jan. 1.

That means one judge will handle probate and trust cases, while the other handles just guardianship and mental health matters.A guardian case manager will also be added. Myers is reviewing software and a database in Pennsylvania that tracks guardian cases, and alerts the state and courts of unauthorized billing or payments.

Fierle had more than 450 wards in more than a dozen counties.

"A statewide system like that would assist us in being able to see firsthand where guardians are working, how many cases they are handling and the potentials for fraud or abuse," Myers said.

Full Article & Source:
Judge looks to make changes guardianship program following Fierle case

Group exploited $264K from elderly St. George woman, charges say

SALT LAKE CITY — Two people face criminal charges and more arrests are expected in an extreme case of elder exploitation in southern Utah.

Prosecutors believe a group of people, led by a man already on parole, exploited an 80-year-old St. George woman out of more than a quarter of a million dollars.

Faye Ann Renteria, 41, of St. George, was charged Thursday in 5th District Court with 10 counts of exploitation of a vulnerable adult, nine second-degree felonies and one third-degree felony. 

Terrence Quincey Powell, 23, also of St. George, was charged with seven counts of exploitation of a vulnerable adult, one second-degree felony and six third-degree felonies. 

On Tuesday, investigators learned that several men were taking advantage of an 80-year-old woman, according to a police affidavit filed in 5th District Court. 

“I learned that the elderly woman had written checks and given these male suspects thousands of dollars in checks and currency,” the investigating officer who works for Adult Probation and Parole wrote in the affidavit.

The woman’s family told police she is “not all mentally cognizant, as she has trouble remembering things, following simple conversation topics, counting, etc.,” the affidavit states.

The family was concerned about one man in particular, a man who is married “but was supposedly engaged to the elderly 80-year-old woman,” according to the affidavit.

Investigators only referred to that man as “the parolee” in court documents.

The woman had reportedly signed the family’s cabin over to this man and given him large amounts of money totaling $150,000 in three payments, the affidavit states, as well as other smaller payments. The woman’s family discovered these transactions while helping her with her bank statements.

The victim met the parolee in March after police say he knocked on her door and told her he believed her home needed repairs and he was willing to do it for a fee. 

“The elderly woman hired the parolee to repaint the stucco around her home, paint the window trimmings, resurface the driveway, miscellaneous yard work, etc. The parolee brought over several of his workers, one of which included Terrance Powell, to assist him,” the affidavit states.

As Powell and others were allegedly working, police say the parolee would talk to the woman and convince her to pay for the services upfront. 

“When I interviewed the elderly woman, I took a look at the home and noted that these odd jobs were never completed, and the quality of work was extremely poor. Any reasonable person can see that these jobs will need to be redone” at a cost of “several thousand dollars,” according to the affidavit. ”None of the work is finished, and appears to have caused more damage to her home.”

Powell is accused of continuing to go with the parolee to the woman’s house to perform small jobs.

“For these jobs however, he was paid several thousand dollars at a time for performing meaningless jobs around the house that shouldn’t cost more than $100 in total,” the officer wrote. 

Powell ended up collecting a total of $13,500 from the woman “for work that he should have been paid less than $100,” the affidavit says.

When Powell was arrested, a family member told police that “it was the idea of the parolee and another male suspect who is at large at this time. However, being that the checks were written in Terrance Powell’s name, it shows that he is just as culpable for taking advantage of her,” according to the affidavit.

After Powell was arrested, agents from Adult Probation and Parole “went to attempt to locate the parolee to arrest him,” a second report states.

Investigators went to a residence in Iron County, but “the parolee fled in a vehicle with three other suspects involved in this scheme. Agents only observed them fleeing, and were too far behind to attempt to stop them,” the report states.

Iron County sheriff’s deputies spotted several of the vehicles and were able to stop one driven by Renteria. She was carrying $12,000 at the time of her arrest, according to the report.

Another man, whose name was not released, was later captured, but “the parolee and a second suspect are still at large at this time,” according to Thursday's affidavit. 

When interviewed by police, Renteria said she is the fiancee of the main parolee suspect police were looking for. Investigators noted that she was “living off” the elderly woman and making “extravagant purchases from the very funds that were taken via deception from the elderly woman.”

“Together she and the parolee purchased an $82,000 GMC Sierra truck, which was the same one she was driving when she was arrested. She also admitted that the $12,000 on her person she received from the parolee who got it from the elderly woman the day prior. Faye also admitted to purchasing a 2018 Chevy Camaro, and a side by side RZR,” the affidavit states.

Investigators believe Renteria and the parolee received at least $264,500 from the St. George woman and said additional charges are forthcoming.

Full Article & Source:
Group exploited $264K from elderly St. George woman, charges say

Lawyer who plundered millions from estates gets prison time

Thomas Lagan is brought into City Court by police officers after being arrested on Friday, Feb. 23, 2018 in Albany, N.Y. (Brendan Lyons/Times Union)

By Robert Gavin

ALBANY — Thomas Lagan, one of two lawyers who took part in a nearly $9 million scheme that victimized the elderly, was sentenced Tuesday to four to 12 years in prison, the state attorney general's office announced.

Prosecutors said Lagan and fellow lawyer and co-defendant Richard Sherwood plundered millions from family trusts they were responsible for overseeing.

Lagan, 60, of Cooperstown, who prosecutors said brazenly continued to use proceeds of the crime even after his arrest and was buying property in Otsego County, pleaded guilty in April to first-degree grand larceny Tuesday before state Supreme Court Justice Thomas Breslin in Albany. He pleaded guilty to federal charges in August.

Lagan is expected to serve his sentence in federal prison. Sherwood awaits sentencing.

"Financial advisors exist to help protect our money, not steal it," Attorney General Letitia James said Tuesday. "These individuals were entrusted with protecting financial assets, but instead, they took advantage of their clients and stole funds for personal use."

So far, law enforcement has recovered $5.5 million in criminal proceeds from the $9.8 million larceny, prosecutors said.

Lagan's admissions followed the guilty plea last year of Sherwood, who was prepared to testify against Lagan under an agreement with prosecutors, court papers show. Sherwood served as a Guilderland town justice until his arrest.

Sherwood admitted he and Lagan wrote eight checks, each for $14,000, to one another, their wives and their children. They used thousands of dollars from the estates of clients to pay for the college tuition of Lagan's daughter.

The scheme evolved after Sherwood and Lagan, who practiced in the area of trusts and estates, began providing legal services and financial advice to local philanthropists Warren and Pauline Bruggeman, as well as Pauline's sister, Anne Urban, in 2006.

Warren Bruggeman, a Queens native who served as a naval officer in World War II, earned bachelor's and master's degrees from Rensselaer Polytechnic Institute in Troy and worked at General Electric in Schenectady at the Knolls Atomic Power Laboratory. He became a vice president at GE, where he overhauled a financially ailing nuclear program into a commercial success.

In 1947, he married Pauline Bruggeman, a Watervliet native and graduate of Troy Business College and Sage Junior College, who later worked as a secretary at Behr-Manning Corporation. Following his retirement, Bruggeman became involved in various philanthropic causes. He also served on the RPI board of trustees.

Sherwood had been advising the Bruggemans when they signed wills directing that all their assets were to go to charities, churches and civic associations, in addition to bequests to Anne Urban and Pauline's other sister, Julia Rentz, according to federal prosecutors.

Warren Bruggeman died in April 2009. Pauline Bruggeman died in August 2011. At the time of her death, her personal and trust assets were valued at about $20 million.

Following the woman's death, Sherwood and Lagan schemed to steal and launder millions of dollars from her estate and the estate of Anne Urban, who died in 2013. Sherwood and Lagan also diverted and transferred several million dollars that belonged to Rentz, who suffered from dementia and died in 2013, prosecutors said.

Full Article & Source:
Lawyer who plundered millions from estates gets prison time

Former senior living employees charged with $300,000 theft from resident with dementia

Two former employees of a Chicago independent and assisted living community have been charged with stealing more than $300,000 from a former resident living with dementia.

Tameeka Wolfe and Christina Wright, the former business manager and activities director, respectively, at Symphony Residences of Lincoln Park, each were charged last week with financial exploitation of an elderly person, a felony, according to media reports.

Wolfe and Wright allegedly stole $136,900 and $205,197, respectively, from resident Grace Watanabe by either transferring money from her account to theirs or by writing themselves checks from Watanabe’s account without permission, the Chicago Tribune reported.

The two are among five former employees of Symphony Residences of Lincoln Park named in a civil lawsuit last year that is ongoing.

Symphony previously said that it had retrained its employees on policies related to accepting gifts from residents; some of the checks allegedly had “Happy Birthday” or “gift” written on them. None of the employees allegedly involved in the incidents involving Watanabe’s funds work for the facility anymore, according to the company. Watanabe, now 98, lives elsewhere now.

In a Facebook post Tuesday, the Office of the Cook County Public Guardian, which now has guardianship over Watanabe, said it was pleased that charges had been filed by the Cook County State’s Attorney’s Office. Altogether, according to the public guardian, $750,000, Watanabe’s entire life savings, has been stolen.

“We are litigating a lawsuit against Symphony and its employees to recover Ms. Watanabe’s money. We have been urging the State’s Attorney’s Office to file criminal charges since the police completed their investigation in February,” the post said. “Criminal prosecution of the offenders, in addition to recovery of the stolen money, is important to achieve full justice for Ms. Watanabe.”

Full Article & Source:
Former senior living employees charged with $300,000 theft from resident with dementia

Federal study finds assisted suicide laws rife with dangers to people with disabilities

The National Council on Disability (NCD) has issued the second in a series of reports on Bioethics and Disability. NCD’s release on the report today focuses on “a federal examination of the country’s assisted suicide laws and their effect on people with disabilities, finding the laws’ safeguards are ineffective and oversight of abuses and mistakes is absent.”

The Disability Rights Education & Defense Fund (DREDF), which worked in partnership with NCD on the series of reports, summarizes this groundbreaking work:

Despite the growing consensus that disability is a normal part of the human experience, the lives of people with disabilities are routinely devalued in medical decision-making. Negative biases and inaccurate assumptions about disabled people persist. In medical situations, these biases can have serious and even deadly consequences.

Beginning on September 25, the National Council on Disability (NCD) is releasing a series of reports on bioethics and disability. The five reports were developed through a cooperative agreement with the Disability Rights Education & Defense Fund (DREDF), which appreciates and acknowledges the valued work of our partners, the Autistic Self Advocacy Network, the Bazelon Center for Mental Health Law and Not Dead Yet, in creating the series.

Each report examines the status and future of how a variety of key issue areas – including organ donation, assisted suicide laws, genetic testing, systems such as Quality Adjusted Life Years, and assumptions about medical futility – are developing due to technological and scientific advances as well as legal changes and healthcare delivery. A combination of original research, stakeholder and scholar interviews, literature reviews, reviews of media reports, and legal analysis is used to examine each topic. Each report includes findings and makes recommendations to lawmakers and policymakers that we hope will ensure that the lives of people with disabilities are valued on an equal and nondiscriminatory basis with all others.

Not Dead Yet specifically consulted on the topics of organ donation, assisted suicide and medical futility.

NCD’s release on today’s assisted suicide report includes the following details, and an example of a seriously mistaken cancer prognosis personally experienced by the NCD Chairman, Neil Romano:

Despite the belief that pain relief is the primary motivation for seeking assisted suicide, in Assisted Suicide Laws and their Danger to People with Disabilities, NCD found that the most prevalent reasons offered by someone requesting assisted suicide are directly related to unmet service and support needs, which NCD urges policy makers respond to through legislative changes and funding.

“Assisted suicide laws are premised on the notion of additional choice for people at the end of their lives, however in practice, they often remove choices when the low-cost option is ending one’s life versus providing treatments to lengthen it or services and supports to improve it,” said NCD Chairman Neil Romano.

Closely examining the experience in Oregon, where the practice has been legal for 20 years, NCD found that the list of conditions eligible for assisted suicide has expanded considerably over time, including many disabilities that, when properly treated, do not result in death, including arthritis, diabetes, and kidney failure.

Assisted Suicide Laws and their Danger to People with Disabilities also notes suicide contagion in states where assisted suicide is legal; as well as a loosening of existing safeguards both in states with legalized assisted suicide and states considering bills to legalize.

In the report, NCD details limitations of purported safeguards of assisted suicide laws, finding:

• Insurers have denied expensive, life-sustaining medical treatment, but offered to subsidize lethal drugs, potentially leading patients to hasten their own deaths;
• Misdiagnoses of terminal disease can cause frightened patients to hasten their deaths;
• Though fear and depression often drive requests for assisted suicide, referral for psychological evaluation is extremely rare prior to doctors writing lethal prescriptions;
• Financial and emotional pressures can distort patient choice;
• Patients may “doctor shop” limitlessly to find a physician who will obtain a colleague’s concurrence and prescribe a lethal dose

“As someone who has battled cancer and been given weeks to live and am still thriving years later, I know firsthand that well-intending doctors are often wrong,” said Mr. Romano. “If assisted suicide is legal, lives will be lost due to mistakes, abuse, lack of information, or a lack of better options; no current or proposed safeguards can change that.”

NCD concludes its research with recommendations, including highlighting the need for:

• Federal research on disability-related risk factors in suicide prevention, as well as on people with disabilities who request assisted suicide and euthanasia;
• Federal regulation requiring non-discrimination in suicide prevention services; and
• Greater federal investment in long-term services and supports.

The NCD report is online at The Danger of Assisted Suicide Laws. The release dates for the other reports in the series are here, with links to the full reports as they become available.

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Federal study finds assisted suicide laws rife with dangers to people with disabilities

$6 Million for Disabled Adults Who Were Punched and Spat At

As part of the settlement, a state agency agreed to surrender control of the facility, known as the Union Avenue I.R.A.. to a private nonprofit agency.CreditCreditDemetrius Freeman for The New York Times

By Benjamin Weiser

It was five years ago in a Bronx group home for developmentally disabled adults that reports surfaced of workers physically abusing and neglecting residents. Some staff members hit and kicked them, gave them cold showers, spit in their faces and left some with black eyes and other bruises.

When the sister of one resident called the facility, a worker answered, “Good morning, Bronx Zoo,” a civil rights lawsuit alleged.

Now New York State has agreed to pay $6 million to settle that lawsuit, which had been brought on behalf of three residents, all profoundly disabled women, ages 39 to 52, who had been abused at the facility, according to settlement papers filed on Monday in Federal District Court in Manhattan.

In addition, the state spent almost as much defending the lawsuit, paying $5.7 million thus far to more than a dozen private law firms retained to represent the state employees named as defendants, according to the state comptroller’s office.

As part of the settlement, the State Office for People With Developmental Disabilities also agreed to take the extraordinary step of surrendering control of the facility to a private nonprofit agency that will oversee the residents’ care using its own employees — a provision the plaintiffs insisted upon, their lead lawyer, Ilann M. Maazel, said.

“We lost all faith that the agency can run this house effectively,” Mr. Maazel said. “The most important thing the families want is for their loved ones to be safe, and they had no confidence that the state would keep them safe.”

Jennifer O’Sullivan, a spokeswoman for the Office for People With Developmental Disabilities, said the proper care and treatment of people supported by the agency “is our highest priority, and this resolution will help ensure these residents receive it.”

The facility, which is known as the Union Avenue I.R.A., includes three group homes housing up to two dozen disabled residents that are part of the network of more than 1,000 state-run group homes.

Laura Kearins, whose 50-year-old sister has lived at the facility since 1992, and who was one of the plaintiffs, said she hoped that the transfer of ownership would be done expeditiously. 

“I pray that it’s a very quick change,” Ms. Kearins said, adding that she wanted all of the Union Avenue residents to “be able to live happy lives, lives that are not lived in fear of what’s going to happen to them next.” 

The settlement comes in a case that not only exposed the mistreatment of the Union Avenue residents, but also revealed a culture in which employees who sought to report misconduct faced retaliation and intimidation. 

For example, a whistle-blower offered detailed accounts of the abuse in a series of anonymous letters to a state official and several families in 2014. The letter writer, who described being afraid of retribution for reporting the abuse, was later identified as a group home employee.

A state investigation later substantiated allegations of misconduct by 13 workers.

But the state failed to fire any of the employees, The New York Times reported in June. 

A state arbitration process shielded the workers who had been cited for abuse and neglect. They were typically sent to other jobs in the system.

Another provision of the deal seeks to bar the employees named in the lawsuit from having contact with any of the three plaintiffs.

The settlement document says the defendants have designated $1.5 million of the state’s settlement as fees for the plaintiffs’ law firm, Emery Celli Brinckerhoff & Abady. But the document also makes it clear that ultimately the judge, Paul A. Engelmayer, and not the state, will decide the legal fees and approve the settlement.

The settlement funds are to be placed in special needs trusts for each plaintiff, the document says.

The lawsuit was scheduled for trial this fall, but at a hearing in April, Judge Engelmayer urged a lawyer for the Office for People With Developmental Disabilities to settle the case, given the “substantial consequences” in potential damages and demands for reform that the state could face if the plaintiffs proved their case.

“The state has an obvious interest in helping control its destiny by helping shape the outcome here,” the judge said. He suggested that the lawyer tell her office that “the judge shook us by the lapels and basically said, this case ought to settle and ought be taken seriously early.”

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$6 Million for Disabled Adults Who Were Punched and Spat At

Editorial: San Diego County should OK conservatorship law to help with homelessness

A San Francisco city worker tells a homeless man that the area next to him on is about to be power washed and points to an area he might want to move to.

(AP)

Authorities need all the tools they can get to help homeless, their communities

By The San Diego Union-Tribune Editorial Board

California’s problem with homelessness is so much worse than it used to be that there’s a sense of helplessness about how intractable the situation has become in Los Angeles, San Francisco, Oakland and — perhaps to a lesser extent — San Diego. The Golden State has 130,000 homeless people, a stunning quarter of the U.S. total, and that number has increased since 2016 by more than in any other state — even as local and state governments spend more time and money than ever on the vexing issue.

Now a new state law that was opposed by just one member of the Legislature before being signed by Gov. Gavin Newsom gives authorities a valuable, if controversial, tool to lessen problems and provide aid to the most troubled homeless residents who can cause the most costly and disruptive problems.

The measure by Sen. Scott Wiener, D-San Francisco, is the product of Bay Area leaders’ frustrations with laws that put limits on how public health officials can deal with and help homeless people who suffer from severe mental illness, addiction or both. It amends and beefs up a bill he got enacted last year that allows county supervisors in San Francisco, Los Angeles and San Diego to set up five-year pilot programs that expand conservatorships, under which a guardian or a protector is appointed by a judge to oversee the daily life of an individual with physical or mental limitations. Without further action by the Legislature, such programs would expire on Jan. 1, 2024.

The law allows these counties to seek to force individuals into first temporary 28-day housing conservatorships and then six-month housing conservatorships after an eighth 72-hour involuntary detention in a 12-month period. Such conservatorships could be requested by the sheriff and by officials with mental health and social services agencies, who are required to establish the necessity of the action with a report on the targeted person’s history. The law includes provisions meant to preserve due process rights by allowing individuals to challenge authorities’ decisions in court. On balance, the measure reflects Wiener’s conviction that it’s “beyond inhumane to sit back and let these people die when we have the ability to help them.”

But that argument was rejected by the ACLU of California, the California Public Defenders Association, the Western Center on Law and Poverty, and Disability Rights California. These groups depicted the proposal as an unwise retreat from individual rights and questioned whether the three counties could provide the services necessary to making housing conservatorships work.

The latter concern is worth considering, given the struggles of local governments in providing adequate homeless facilities. But Wiener says that the standard requiring that only individuals who have faced multiple “5150” detentions could be subject to conservatorships means only about 1% of the homeless in San Francisco could potentially be affected. That’s likely true in San Diego County as well.

In an interview Thursday with The San Diego Union-Tribune Editorial Board, San Diego City Attorney Mara Elliott said conservatorships “can be a very valuable tool. There are certain individuals who need more help ... [they’re] not going to be helped with a shower or services.” Elliott added that the requirement that a judge agree to the conservatorship provides due process.

The case for conservatorships is persuasive. The Board of Supervisors should begin evaluating a county pilot program as soon as possible. As Elliott said, officials need all the tools they can get to help the homeless and the communities where they live.

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Editorial: San Diego County should OK conservatorship law to help with homelessness

Lincoln County police chief indicted on charges of exploitation of the elderly

Old Monroe Police Chief Kimla Lowery

OLD MONROE, Mo. (KMOV.com) -- A Lincoln County police chief has been indicted on charges of exploiting an elderly person suffering from dementia.

Records allege that Old Monroe Police Chief Kimla Lowery abused and used her position as police chief to take control of the 96-year-old elderly and disabled victim's finances, property, mail and medical decisions.

In June 2018, the Missouri Department of Health and Senior Services, Criminal Investigation Division, initiated an investigations into the financial exploitation.

"The Lincoln County Prosecuting Attorney's Office is taking these allegations seriously and will prosecute aggressively cases involving public corruption and abuses of power. Those who hold the public trust must be held to the highest standards," said Prosecuting Attorney Mike Wood.

Lowery faces up to 43 years in prison if convicted and fines totaling $80,000 or both.

Additional charges are being considered.

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Lincoln County police chief indicted on charges of exploitation of the elderly

Former probate judge sanctioned

By JORDAN CUDDEMI

CHELSEA — A former Orange County probate judge has been publicly reprimanded by the Vermont Judicial Conduct Board for failing to dispose of matters “promptly, efficiently and fairly” in a family’s long-running guardianship dispute involving adult children of an elderly Newbury, Vt., woman.

Bernard Lewis, who was on the bench in probate court from 2002 until January, didn’t complete hearings or rule on motions in Miriam Thomas’ guardianship case in a timely fashion, nor did he follow up or enforce orders or hold parties accountable, according to the reprimand written by Judicial Conduct Board Chairman Andrew Maass dated Sept. 6. Siblings Elizabeth Guest and Bruce and Bryce Thomas alleged their brother, Paul Thomas, repeatedly abused his powers as their mother’s guardian and Lewis did little to stop it.

“The repeated failure to address and decide issues that came before the Judge related to the conduct of the guardian caused petitioners to incur significant attorney fees and resulted in inefficient use of both parties’ and the Court’s resources thereby constituting a failure to dispose of all judicial matters promptly, efficiently and fairly,” the reprimand states.

“The chronic failure to hold the guardian accountable for his actions with respect to his obligations while allowing him to pay himself enormous amounts of money over 7 ½ years, despite repeated filings that brought such issues to the Court’s attention, exemplifies a failure to dispose of issues fairly.”

Bruce Thomas on Thursday called the reprimand a “moral victory,” but said the harm Lewis caused through his handling of the case will be lasting.

“Although the damage Judge Lewis has caused our family continues to this day, it represents a moral victory of sorts — at least he was not able to sneak off into retirement without any sort of rebuke,” Thomas said in an email. “While this case is over for Judge Lewis, he created one very costly mess for all of us.”

Lewis no longer is a presiding judge in Vermont; he didn’t seek reelection and his term expired in January.

Reached this week, Lewis, whose attorney signed the finding agreeing on a reprimand, said there is more to the story, but he declined to elaborate.

“(This case) is a lot more complex than what is reflected in the reprimand,” the 75-year-old Lewis said. “I don’t think I did anything wrong. I was on the bench for 16 years and I had a lot harder cases than that.”

If he hadn’t decided to retire, he would have fought this to “the bitter end,” Lewis said.

Lewis has practiced law in Randolph and previously worked for Vermont’s Department of Banking, Insurance and Securities as a market conduct chief examiner.

The investigation into Lewis’ actions started in January 2018 when three of Paul Thomas’ siblings, including Bruce Thomas, filed a complaint to the conduct board, alleging Lewis engaged in a “pattern of inaction,” among many other things.

Judicial Conduct Board investigator John Kennelly, who acted as investigative counsel for the board, filed a formal complaint in January of this year over Lewis’ handling of the case, asserting Lewis violated provisions of the judicial cannon that states a judge “shall perform the duties of judicial office impartially and diligently.”

The parties went through discovery for a few months before Kennelly and Lewis’ attorney, Christopher Davis, last month jointly stipulated that a public reprimand was in order.

The matter is subject to review by the Vermont Supreme Court.

Miriam Thomas, who had dementia and was living in the memory care unit of an Upper Valley nursing home, died earlier this year at 94. She and her late husband, Fredrick Bryce Thomas, owned several pieces of real estate, including a tree farm. Together they ran their 21-room Pulaski Street home as the Newbury Inn.

After she went to the facility, Bruce and Bryce Thomas and Elizabeth Guest filed a guardianship petition, but siblings Paul Thomas and Mary Thomas filed a counterpetition seeking to appoint Paul Thomas. Lewis appointed Paul Thomas as financial and medical guardian in 2010.

The sibling trio objected to accounting reports annually that Paul Thomas had filed, alleging he wasn’t following guidelines that govern guardians and was abusing his power. The siblings and Kennelly alleged Paul Thomas had paid himself more than $250,000 from his mother’s assets for serving as guardian. Lewis removed Paul Thomas as guardian in March 2018. The siblings spent hundreds of thousands in attorneys fees, according to Bruce Thomas and Kennelly.

Bruce Thomas, who works in the insurance industry in Connecticut, said he is still waiting for the court to hold a hearing on the matter.

“We would like not to have to think about this anymore, or spend any more time or money on this,” said Bruce Thomas, who hopes that the court will “uphold Vermont’s guardianship laws and order restitution.”

Attempts to reach Paul Thomas were unsuccessful. However, his attorney, John Page, told Seven Days last month that “(Any) published statement to the effect that Paul Thomas received excessive compensation as his mother’s guardian would be inaccurate, or at least unproven.

“That issue has yet to be adjudicated and therefore remains mere allegation until the court hears all the evidence and makes a ruling,” Page told Seven Days.

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Former probate judge sanctioned

AJC’s ‘Unprotected’ spurs outrage, calls for change in senior care

By Brad Schrade Carrie Teegardin

The Atlanta Journal-Constitution’s investigation detailing abuse and neglect across Georgia’s senior care industry prompted dozens of readers to share their own harrowing experiences and call for improvements to a system that impacts thousands of families.

“I felt like somebody was shining a light on a problem,” said Karen Goode, who said her mother with Alzheimer’s died in August, just 12 days after a serious fall at a facility in North Fulton where she had lived for a decade.

Like many families, Goode said they paid thousands a month, yet the facility always seemed short-staffed with a new director who cycled through almost every year. Goode was among the readers who emailed or called the AJC after publication of the series, which identified more than 600 cases of neglect and 90 of abuse in assisted living communities and large personal care homes across the state.

“The industry is so broken,” Goode said. “Even a series so compelling like this will not fix anything unless lawmakers get off their butts and do something.”

Gov. Brian Kemp’s office and several lawmakers said the series revealed problems that needed to be addressed.

“Every Georgian should be able to age gracefully and with dignity in their communities,” said Cody Hall, Kemp’s press secretary. “These reports highlight serious issues involving care for aging adults, and we look forward to working with the Department of Community Health, state leaders, and local partners to review the current framework and identify areas for improvement.”

State Rep. Sharon Cooper, R-Marietta, who chairs the House Health and Human Services Committee, said she plans to introduce legislation when the Georgia General Assembly convenes in January. She wants to look at high staffing ratios at facilities, adding more state inspectors and other changes.
She said she’s heard from constituents about the AJC series, many of whom are bothered by the way seniors are treated.

“I tell them I’m working on it,” she said. “I don’t believe there’s a panacea that will make everything perfect, but there are certainly changes we can make that will move us a long way to the goal that we treat our seniors with the respect, dignity and care they deserve.”

State Rep. Jesse Petrea, R-Savannah, who chairs the House Human Relations & Aging Committee, said the Legislature has been proactive in recent years to protect seniors. He wasn’t ready to submit policy proposals in response to the series, but said he hopes lawmakers will do “anything in our power” to protect the most vulnerable in society.

“I’m all in for that,” he said. “The difficulty is knowing exactly how we could have altered some of these terrible outcomes.”

State Sen. Kay Kirkpatrick, R-Marietta, said the state has a responsibility to protect its vulnerable citizens, but the senior living industry also needs to take a “serious, introspective look” at itself and find ways to improve care.

“It’s in the best interest of the industry to be proactive and work on these issues,” said Kirkpatrick, a physician who is a member of the Senate Health and Human Services Committee. “Otherwise, it’s just a black eye on them. I think they should be leading the charge on this.”

Industry: some change needed

The AJC uncovered conditions and incidents in senior care homes that must be “halted, corrected and punished,” said Vicki Vaughn Johnson, chair of the Georgia Council on Aging, a 20-member body created by the General Assembly to advise elected officials and state agencies.

The council includes both consumers and senior care service providers.

Johnson said the state must dramatically increase fines against facilities for violating care standards. The current fine structure    allows a $601 penalty against facilities in serious first-offense cases involving harm and death.

She called that amount “incredible, unbelievable and unacceptable.”

Johnson praised the thousands of direct care workers in Georgia who have the best interests of residents at heart, but she said they are often asked to care for too many people and with too little training. She called for the state to increase staffing and training requirements. Johnson urged Georgia citizens to contact state lawmakers to push for change.

“It’s in the best interest of the industry to be proactive and work on these issues. Otherwise, it’s just a black eye on them. I think they should be leading the charge on this.” —State Sen. Kay Kirkpatrick, R-Marietta

The senior care industry also responded to the AJC’s reports and acknowledged that some changes may be needed.

Saying it had “great intolerance for wrong-doing or substandard care,” the Georgia Senior Living Association said in a statement that it would support more state inspectors and “robust, unannounced inspection efforts.” It also called for more training for workers, as well as best practices in Georgia to reduce falls and improve care for residents with dementia.

The association said it would support enhanced reporting requirements in cases of suspected crimes and abuse.

“As an association that wants the best operators in the country, we will continue to advocate for high standards of care for all citizens of Georgia,” the association said in a statement.

Still, the association objected to the way the AJC investigation portrayed the industry.

“The AJC’s spotlight seems to only illuminate the negative, while the stories of hundreds of thousands of positive outcomes within the industry go unreported,” the association said in the statement.

‘Exploitation is unacceptable’
 
The Georgia Health Care Association, which represents nursing homes, assisted living communities and other senior care providers, said it has a history of working with state government officials to make improvements, including a better background check system for caregivers that went into effect this month.

GHCA’s president Tony Marshall said the association supports better education for operators about the reporting requirements for abuse, neglect and exploitation.

“The safety and well-being of elderly Georgians is GHCA’s highest priority, and any instance of poor care, neglect, abuse or exploitation is unacceptable,” said Tony Marshall, GHCA’s president.

The Culture Change Network of Georgia, a coalition of senior care providers, consumers and advocates, also responded to the AJC’s series, saying the coverage “shines a light on cases of inadequate care, abuse and neglect” that it wants the state to address through a careful review of current policies, laws and enforcement.

“We believe that everyone must be a stakeholder in improving the quality of care and quality of life for older Georgians,” the network said in a statement.

While many readers expressed gratitude that the AJC investigated the senior care industry, some were painfully reminded of their own family’s story.

Dave Markus’s 89-year-old father died nearly four years ago when he choked to death on a piece of steak in a Buckhead facility’s dining area. He said no one at the facility did anything to save him.

Markus just retired himself and he thinks the state needs to do more to regulate caregivers and companies. He and his wife wonder where they’ll turn when they need care.

”I’ve got no family behind me, no siblings. I’ve got no children,” Markus said. “We’re kind of concerned when one of us goes we don’t think there’s going to be anybody to look out for us.”

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AJC’s ‘Unprotected’ spurs outrage, calls for change in senior care

Joy's House helps Charlene stay at home. It could close and send her into a nursing home.

Lisa Fisher had almost despaired of finding a way to keep her mother who has Alzheimer’s out of a nursing home. Place after depressing place that she visited reduced Fisher to tears.

Then she found Joy’s House, which provides daytime care for adults, many of them seniors who have physical and mental challenges. Each morning Fisher drops her 83-year-old mother, Charlene, off at Joy's House, and each night she picks her up and brings her back to the home she shares with her husband, Fisher's father.

But the Fisher family may soon need to explore other alternatives. Joy’s House, which opened 20 years ago in Broad Ripple, has run into financial difficulties and may be forced to close its doors.

The predicament reflects the challenges families face as they try to help their elderly relatives "age in place," or in other words stay in their homes as they grow old. Doing so tends to be far less costly than moving to a nursing home, particularly for seniors who need just a moderate level of help.

But nursing home care remains the big ticket in adult services. Less intensive services like adult day centers can wind up struggling to stay afloat.

For Joy's House, fewer donations, Medicare rules, potential changes in Medicaid reimbursement, and Indiana's woeful track record caring for seniors based on one reputable assessment all compound the problem, said Tina McIntosh, Joy’s House founder.

“There’s a lot of things. It’s kind of the perfect storm,” she said. “If Joy’s House doesn’t make it, we want to make sure that people in our community understand that aging needs to be a priority.”

'Indiana is not doing well'

An AARP scorecard ranks Indiana as the worst in the country when it comes to providing long-term services and support for older adults, people with disabilities and their caregivers. Most of the Medicaid dollars in the state go to supporting nursing home care, said Sarah Waddle, state director of AARP Indiana.

“Indiana is not doing well as it relates to making sure that there are different options for people as they age,” she said. “We’re very out of balance. … There is a time and place for nursing home care, and that is needed. But let’s not jump to that option before we need to.”

State officials would like to shift that imbalance slightly. They are applying for federal approval to increase the reimbursement rate for adult day services for Medicaid recipients with more acute needs, something many other states do.

However, that change also would bring a decrease in the amount the state pays for adults who need a lower level of service.

Under the system, which will go into place in February 2020 if the government approves it, the state will increase its spending on adult day services by 6.2% a year, said Jesse Wyatt, deputy director of aging for the Family and Social Services Administration. Providers now receive a set amount of reimbursement per person regardless of whether they provide level three care, the most intensive level of services, or level one care, the lowest level.

“We wanted to correct that so we are incentivizing providers to make sure they are taking individuals with higher needs,” Wyatt said. “Today there’s a disincentive for adult day providers to take any one but level one.”

If this change were to go through, however, it would only add to the financial challenges for Joy's House.The adult day center accepts only those who qualify for the lowest of the three levels of service.

And while the center could opt to accept people with a higher level of need, that would require it to hire a nurse, which would cost more, McIntosh said.

“What is unfortunate is that it feels like a penalty for serving individuals who are not yet in need of acute care,” she said.

Keeping families together 

More than two decades ago while she was in college, McIntosh worked at a local adult day center. There she met a beautiful woman in her 90s with bright red lipstick painted on casually, almost like a child had applied it. The woman lived in her own world until she sat down at a piano, and it was then her younger self came rushing back, McIntosh recalls.

A few years later at age 27, McIntosh decided to open her own center in Broad Ripple, a neighborhood known more for its younger inhabitants than its older ones. She wanted a center that looked like a house and not like, well, a center.

She designed the facility so clients would feel like a guest in someone’s home with activities that would stimulate them, like music and crafts.

Originally, some people suggested naming the center after one McIntosh's grandmothers: Ethel or Edna, McIntosh said. The group wound up choosing Joy's House because of the emotion the name evokes.

Ten years ago, the facility expanded, allowing it to increase the number of guests each day from 23 adults to as many as 42 guests. A few years later, Joy’s House took over an adult day center on the south side, which serves about a dozen people a day and acts as a learning lab for University of Indianapolis students.

While the centers serve some younger adults, more than 70 percent of their guests have some form of dementia, McIntosh said. Others have mild developmental disabilities or require care because of conditions such as a stroke, multiple sclerosis or Parkinson’s. Most spend nights with a family caregiver, such as a spouse or adult child.

“Most of us as we age, our goal is to live at home with people whom we love the most,” she said. “We keep families together in their homes.”

But it comes at a price. The daily rate for care from 7 a.m. to 6 p.m. in Broad Ripple is $75 a day, $70 at the south-side location.

Nursing home care is costlier. On average, nursing home care in the United States costs $225 a day compared with $68 a day in an adult day center, according to the U.S. Department of Health and Human Services. 

Joy’s House thrived for years. About a decade ago, when the center expanded, it was able to buy the building. The facility, which has a staff of about 20 people, offers scholarships for those who do not qualify for the Medicaid waiver and do not have the means to pay.

One of the challenges that Joy’s House and other adult day centers face is that unlike health care, Medicare does not cover the services they provide, said Kathy Pellman, director of Still Waters Adult Day Center, which has two Indianapolis locations, which emulate the Joy’s House model. Long-term care insurance may reimburse for it, but many people lack that benefit.

Studies suggest that most of those who use adult day services cover the costs through Medicaid. While the changes that Indiana wants to make to Medicaid reimbursements could help some adult day centers, Pellman said, having the federal Medicare program cover the service would make even more of a difference.

If that were to happen, adult day centers could expand the social services they offer to include some health-related services, such as overseeing medication and monitoring clients’ vital signs and diets.

“The biggest thing our industry nationally is looking at is making adult day services a Medicare benefit,” Pellman said. “I think that’s the future of our industry because they’re going to realize we’re part of the health care spectrum anyway.”

A warm and comforting home

For Charlene Fisher and her family, Joy’s House has been nothing short of a godsend. The center stood out from all the other options Lisa Fisher saw when she sought to find a place for her mother. 

“The very first thing that struck me was it looked like a home,” Fisher said. “It wasn’t industrial at all. … It’s very warm and comforting.”

Charlene has seemed happier since she started going to Joy's House, Fisher says. She's more interactive and follows conversations better.  

Every morning, Lisa Fisher drops her mother between 8 and 8:30. Every evening she picks her up around 5. During the day, "Miss Charlene," as she is known, enjoys singing, listening to music and doing crafts.

Not only has the center improved Charlene's days for her, it also has meant that she now sleeps through the night instead of wandering around.    

    

If the center were to close, Lisa Fisher said, her mother would most likely have to move to a nursing home.

“That makes me really sad. I have not found another place that I would feel comfortable leaving her,” she said. “Every day when I drive away I think it’s a miracle that I can leave her there.”

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Joy's House helps Charlene stay at home. It could close and send her into a nursing home.