Saturday, June 18, 2022

For some adults, it takes a team, not a guardian, to make life decisions

I am 19 years old and live with my family. I happen to have autism and am a cancer survivor. A lot of people like me have a guardian. I don’t. Instead, I use something called supported decision-making.

This is an alternative to guardianship where individuals pick a group of people they trust to help them make decisions. I am the decision-maker in my life.

State Senator Joan Lovely and Representative Paul Tucker have proposed a bill to provide a legal framework for supported decision-making in Massachusetts. I testified in favor of the bill at the State House. Passing this law would mean more people who want to could use supported decision-making. Fourteen other states and the District of Columbia already have laws like this one.

When I was in school, my mother and I were told that I needed full guardianship. This didn’t feel right for us. My mom had learned about supported decision-making and we found it was a great alternative for me. I chose my supporters and decided on the support I wanted.

Then came cancer. I was diagnosed during the pandemic. My supported decision-making team proved essential in helping me make my own decisions. Fighting cancer has been one of the hardest journeys of my life. But I was able to let my body and voice guide me, with support from my parents and others. I am so thankful for the freedom I’ve had to choose my treatments.

COVID-19-related visitor restrictions made supported decision-making harder. We had to advocate with the hospital to have my supporters with me at appointments. A law would make it easier for people to have supporters with them anywhere they need them.

Guardianship would have been worse than death to me because I would have lost my choice. I fully trust my team, but I want to make choices for my own life, and this law would protect that process.

Jonathan Gardner

East Bridgewater

Full Article & Source:

‘FINAL DISRESPECTS’: Marlboro County voters oust probate judge Mark Heath

Marlboro County Deputy Probate Judge Tammy Bullock walks into Hollis Slade’s home on Jan. 24, 2021 the day following his death. Bullock told someone in a phone call recorded on Slade’s back porch that she and the others spent the day “rummaging” through Slade’s home in search of a will.

MARLBORO COUNTY, S.C. (QUEEN CITY NEWS) — When the polls closed Tuesday night, Judge Mark Heath knew his days as the Marlboro County Probate Judge were over. Heath, first elected to the position in 1998, was beaten soundly in the June 14 Democratic primary.

Heath was unable to win a single precinct out of the 15 up for grabs in Tuesday night’s primary. 

Election results show Heath collected 342 votes – 13.4% of the total – out of the 2,540 votes cast. Heath lost his seat to Reneka McQueen McCoy who won the primary with 50.4% of the vote, or 1,280 votes. There is no Republican challenger.  

The primary result means Heath will no longer hold office when his term ends on Dec. 31, 2022.

The Marlboro County Board of Voter Registration and Elections confirmed Heath’s primary loss in a call Thursday. The board confirmed the probate election was confirmed final by state elections officials this week. 

Heath became part of our ‘Final Disrespects’ investigation last fall after his deputy probate judge, Tammy Bullock, was accused of ransacking a dead man’s home in January 2021 looking for a will. The man, Hollis Slade, died after a sudden illness and multiple security cameras captured Bullock and others discussing searching Slade’s home for a will.

The recordings also show Bullock and the group talking about concealing financial information the found in Slade’s home from his family. The videos also show some in the group walking out of the Slade home with property – all while Slade’s wife was inside. 

Slade’s wife, Joyce, suffers from dementia and requires full time care.  

Marlboro County Deputy Probate Judge Tammy Bullock looks at a FOX 46 camera as she watched our crew record video outside the county courthouse on Sept. 24, 2021. (WJZY Photo/Jody Barr)

The family filed criminal complaints against Bullock and the group, accusing Bullock of impersonating a public official and the others of theft. Bullock, Slade’s family alleged, introduced herself as a probate judge, although Bullock was not sworn in at the time.

Heath had appointed Bullock as the county’s deputy probate judge at the time of Slade’s death. She wasn’t administered an oath until mid-March.

The South Carolina Law Enforcement Division initially declined to investigate the Slade family’s complaint, telling Queen City News Chief Investigator Jody Barr the acts depicted in the video recordings were a “civil matter.”

Slade’s neighbor, Bobby Norris, told QCN he reported the videos and the allegations concerning Bullock to Heath on Jan. 29. When we questioned Heath about Norris’ call Heath would not talk about the call, what Norris told him, or what action he took to address the complaint.

Bullock continued working at the probate office until Oct. 27 when she resigned “effective immediately.” Bullock’s resignation happened on the final day of the South Carolina Association of Probate Judges’ annual conference at a Myrtle Beach resort. We found Bullock’s Cadillac SUV at the conference on the first day, but could not find Bullock or her vehicle on the final two days of the conference.

We found Heath at the conference and attempted to interview him as he got onto an elevator. Heath would not speak with us and a few minutes later, we saw Heath and his wife loading their luggage into the car and got back on the highway to Marlboro County. 

After we filed a South Carolina Freedom of Information Act with SLED requesting access to the Slade complaint, SLED denied the request claiming an exemption that allows agencies to block release of records while a criminal investigation is underway. SLED later claimed an internal “miscommunication” led to the agency telling QCN the Slade complaint was a “civil matter” and that the agency actually had an active investigation underway at the time.

When we last asked SLED and the South Carolina Attorney General for an update on the Slade investigation on April 29, the agency confirmed the investigations were still open. After SLED closes its investigation, the agency will submit the case file to the AG’s office for a prosecutor to determine whether anyone will face charges.

Full Article & Source:

'FINAL DISRESPECTS': Marlboro County voters oust probate judge Mark Heath - YouTube Video



Friday, June 17, 2022

Some People With Disabilities Were Abused And Neglected After Global Company KKR Took Over More Than 600 Group Homes

This is a plain language version of a story published earlier this year, adapted by Sandy Mislow of the Self-Advocacy Association of New York State. Plain language is a type of writing that uses common words, short sentences, and images to make information more accessible.

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BrightSpring Health Services is a nationwide organization that provides support and services to people with disabilities. It was bought by a large investment company called KKR in 2019. BuzzFeed News investigated neglect, abuse, and death suffered by some people who lived in group homes run by BrightSpring. Here are the main things our investigation found:

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1. BrightSpring runs more than 600 group homes for people with severe intellectual and developmental disabilities. Many of these people need help to bathe, eat, or communicate.

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2. Since KKR bought BrightSpring, many of its group homes haven’t had enough staff members to keep the residents safe. After finding dangerous conditions in several homes, a state prohibited the company from accepting new residents. Some residents died. Despite these problems, BrightSpring bought even more companies to expand its business.

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3. No one was watching when one man walked out of his group home. He got hit by a car. Another person who was left alone drank a poisonous chemical and did not get medical help for more than 9 hours. Someone else choked to death, and staff called the supervisor first instead of 911. Other residents were given the wrong medicine or no medicine at all. One woman was restrained in her bed and left alone; she later died from the injuries.

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4. From March 2019 to December 2021, many group homes run by KKR and BrightSpring were found to be very dangerous. Safety inspectors found problems more frequently at these homes than homes run by other organizations.

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5. A manager named Perry McAfee, who supervised 60 group homes, said that BrightSpring was more concerned about making money than providing high-quality services.

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6. Group home managers told their bosses at BrightSpring that they couldn’t get enough staff because the pay that was offered was so low. Several times, safety inspectors visited homes and found no staff at all. The people living in them were alone with no help.

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7. Some staff did not get enough training on how to properly support the people who lived in these homes.

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8. Staff sometimes had to work 3 days in a row without being allowed to go home. Some said their bosses threatened them with arrest if they tried to go home. Also, when staff did bad things, they were not always fired. One staff member pulled a gun on a client's family member and was not immediately fired.

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9. Some nurses quit because they were afraid that they would lose their nursing licenses if they kept working somewhere that was so unsafe. They warned their bosses that some people living in these homes could die because of the poor care they were given.

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10. Group home managers said their supervisors made them take in new people into the homes, even when there were not enough staff to support them.

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11. KKR approved a plan for BrightSpring to borrow over $1 billion to buy more companies. Because of this, BrightSpring had to pay more than $135 million each year in interest fees. This money could have been spent on improving the group homes and increasing staff pay.

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KKR and BrightSpring said they strongly disagree with the information being reported about them. They said it was incorrect and gave readers the wrong idea.

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KKR told BuzzFeed News that it spent $200 million per year on its group homes to improve the quality of care provided, and it has increased staff pay by 28% since 2019. BrightSpring said 99.99% of the time spent supporting people in its group homes was without any incidents, and that medication was properly given 98% of the time.

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 Full Article & Source:

General Assembly approves to lower elder financial exploitation age

by Kevin Perrington-Turner

PROVIDENCE, R.I. (WLNE) — The General Assembly approved a bill Thursday that would lower the age of eligibility for a Rhode Islander to be considered a victim in elder financial exploitation.

Currently, Rhode Islanders are required to report elderly exploitation for anyone 60 or older, however, a person can’t be charged unless the victim is at least 65.

If passed, the bill will lower that age to 60.

Senator Cynthia Armour Coyne, who helped fight against elderly financial exploitation from 2018 to 2019, wants to help protect residents.

She said, “This legislation closes a confusing and unintended gap between our requirement to report abuse and when charges can be brought for elder financial exploitation. Ultimately, it also protects more Rhode Islanders. A wider definition better ensures that more cases can be successfully prosecuted, and ultimately provides greater protection to Rhode Islanders.”

Elder financial exploitation is the illegal mishandling of an elderly persons funds. Typically using trust to gain access to someones financial resources.

The bill will now go to the governor.

Full Article & Source:

Thursday, June 16, 2022

A Proclamation on World Elder Abuse Awareness Day, 2022



It is more vital than ever that we ensure our older adults can age with the dignity, security, and appreciation that every person deserves.  Honoring and respecting older Americans is a matter of basic human dignity and justice — it is part of the character of our Nation.  Yet every year, many Americans aged 60 and older experience abuse and neglect.  On World Elder Abuse Awareness Day, we join the international community to raise awareness and help end elder abuse here at home and across the world. 

Elder abuse takes many forms, such as financial, emotional, physical, and sexual harm, including intimate partner violence in later life.  It often comes in the form of neglect, abandonment, or exploitation.  It is estimated that approximately 1 in 10 elderly Americans are abused annually.  However, many of those who are abused suffer in silence, and many cases are never reported or brought to light.  In the past few years, while the pandemic isolated all of us to different extents, it especially exacerbated the isolation felt by too many older adults.  All of us have a role to play in preventing elder abuse and ensuring that our Nation’s seniors are able to age with dignity.  With a majority of elder abuse victims being women, my Administration is focused particularly on improving our support for all women and preventing and addressing gender-based violence that impacts older adults both domestically and abroad.

We must remain steadfast in our commitment to preventing elder abuse.  My Administration allotted $178 million through the American Rescue Plan and the COVID-19 recovery bill to improve and strengthen the work of Adult Protective Services (APS).  Additionally, my budget proposal for 2023 would provide ongoing support for APS and State Long-Term Care Ombudsman programs.  Our comprehensive, collaborative efforts to respond to elder abuse, neglect, and exploitation include initiatives to reform guardianship, support adult decision-making, crack down on scammers and fraudsters, and empower victims of exploitation.  Our commitment to supporting survivors of all ages is reflected in the reauthorization of the Violence Against Women Act, which includes dedicated Federal funds to support survivor service providers, law enforcement, and prosecutors working to respond to domestic and sexual violence experienced by older adults.

As we continue to build a better America, we must ensure that we bring everyone along.  That is why my Administration is committed to safeguarding the rights of those who live in retirement and shared residential settings.  I have called on the Congress to deliver significant reforms to improve the safety and quality of care in our Nation’s nursing homes.  Recognizing the critical work of caregivers, I have also proposed measures to create a strong and well-compensated caregiving workforce to advance the well-being of our Nation’s older adults.  By ensuring a high quality of life and care for older Americans, we can support every community and honor the dignity of every person. 

On this World Elder Abuse Awareness Day, let us recommit to delivering all older Americans the promise of a comfortable and peaceful life with dignity.  Let us reaffirm our commitment to a world free from the scourge of abuse and neglect.  Let us join the world in celebrating the essential role older adults play in our lives.  

NOW, THEREFORE, I, JOSEPH R. BIDEN JR., President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim June 15, 2022, as World Elder Abuse Awareness Day.  I encourage all Americans to be diligent, work togetherto strengthen existing partnerships, and develop new opportunities to improve our Nation’s prevention and response to elder abuse, neglect, and exploitation.

IN WITNESS WHEREOF, I have hereunto set my hand this fourteenth day of June, in the year of our Lord two thousand twenty-two, and of the Independence of the United States of America the two hundred and forty-sixth.

                               JOSEPH R. BIDEN JR



House Approves Ban On Electric Shock Devices For Those With Developmental Disabilities

by Michelle Diament

A bill that would ban the use of electrical stimulation devices to address self-injurious or aggressive behavior is now headed to the U.S. Senate. (Thinkstock)

Congress is moving to ban devices used to administer electric shocks on people with developmental disabilities in an effort to modify their behavior, a practice that advocates have long decried as torturous.

The U.S. House of Representatives voted 392 to 28 last week to approve the Food and Drug Amendments Act, a broad bill reauthorizing programs at the Food and Drug Administration. Tucked inside the legislation is a provision that would put an end to the use of what are known as electrical stimulation devices, which send shocks through electrodes attached to the skin in order to condition people not to engage in self-injurious or aggressive behaviors.

The devices are believed to be used at only one facility in the U.S. — the Judge Rotenberg Educational Center in Canton, Mass., which serves children and adults with developmental disabilities as well as those with behavioral and emotional problems.

Disability advocates have worked for years to bar the practice. And in 2020, the FDA finalized a ban on the devices after determining that they pose an “unreasonable and substantial risk of illness or injury.” The agency cited evidence of psychological and physical risks including burns, tissue damage, worsening underlying symptoms, depression, anxiety and post-traumatic stress disorder.

But the Rotenberg Center sued and last summer the U.S. Court of Appeals for the D.C. Circuit found that the FDA had overstepped its authority and overturned the regulation.

The legislation now heads to the Senate where advocates say they are hopeful that the provision banning electrical stimulation devices will be included.

“Contingent electric shock for the purposes of behavior modification is inhumane and ineffective and has been condemned by the United Nations as torture,” said Julia Bascom, executive director of the Autistic Self Advocacy Network. “We hope the Senate will act swiftly — folks subjected to these shocks have been waiting for far too long.”

Supporters of the Rotenberg Center, however, are not backing down on what they say is a last resort for individuals with severe behaviors who have not responded to other treatments.

“The parents and guardians of clients of the Judge Rotenberg Educational Center (JRC) will continue to fight to preserve the life-saving electrical stimulation device (ESD) treatment for our loved ones, for whom all other treatment options have been tried and failed,” the Judge Rotenberg Educational Center Parents Association said in a statement to Disability Scoop. “Were the proposed legislation to be enacted, it would destroy the significant gains that have been achieved due to this treatment and inevitably result in self-mutilation and the reemergence of other severe behaviors that will lead to irreparable harm, permanent disfiguration, or even the death of our children.”

Full Article & Source:

Tuesday, June 14, 2022

Pop-Art Icon Peter Max’s Daughter Files New Suit Calling His Guardianship ‘Inhumane’

 by Tatiana Siegel
The new filing is the latest in a series of ongoing efforts by Libra Max to have more say in her 84-year-old father’s care as he suffers the effects of Alzheimer’s-related dementia

As his Alzheimer’s-related dementia has progressed, a series of legal battles surrounding Max’s care — marked by familial infighting, numerous challenges to the guardianship, suits and countersuits — have escalated. In the latest of these lawsuits, filed Tuesday in New York State, Libra, 55, alleges that Max’s current court-appointed guardian has, among other things, inflicted severe emotional distress on Libra by isolating Max from family and friends and withholding information about Max’s health from Libra. The suit also alleges that Max’s guardian has lied to the court in the guardianship case.

“My father should never have been put into a guardianship in the first place, and he should not be in one now,” Libra tells Rolling Stone. “[He] has a loving daughter, me, and he has been begging for me to come care for him, just as my father did for his own father. It is our family culture to care for our own.”

The recent drama began in the months leading up to Lang’s 2019 visit, when Max’s second wife, animal rights activist Mary Balkin, petitioned a New York court to install a new guardian. On June 9, 2019, the New York Times published an exposé about how Max’s dementia was allegedly being exploited by his business associates for financial gain. (Max’s estate is estimated at hundreds of millions of dollars.) The Times also reported allegations of abuse and neglect against Balkin, who took her life days later.

Within 24 hours of Balkin’s death, a court appointed Barbara Lissner, an attorney whose firm was founded by her father-in-law to help Holocaust survivors like Max, as the artist’s new guardian. But the situation quickly devolved. Three months later, with support from a group of Max’s friends and 17 of his cousins, Libra made the first of several so far unsuccessful attempts to end Max’s guardianship or at least to remove Lissner from the role.

In a 2020 affidavit submitted as part of these efforts, Lang alleged that he’d been unable to reach Max at home or in his studio since Lissner, 67, had taken over his care. “This is an absolute tragedy,” Lang stated. “I miss Peter deeply, and am very worried about him. … I’m sure that Peter’s current state — isolated and cut off from his family and close friends — is a depressing situation for him. This is simply not like the life he’s loved and lived.” (Lang never saw Max again; the legendary concert promoter died of Non-Hodgkin’s lymphoma last January.)

Lissner, meanwhile, recently brought a defamation suit against Libra — a move Libra’s new filing alleges violates New York’s so-called anti-SLAPP law, which is meant to prevent the use of lawsuits brought to intimidate people from exercising their free speech and public petition rights. For her claims against Lissner, Libra is asking for damages in an amount to be determined at trial.

Libra says she is fighting the conservatorship system in order to have more access to her father, to be free to take him to a doctor and be more involved in his medical care. Libra and her brother, Adam, are already the co-heirs of his estate, and she insists that her quest to emancipate Max has nothing to do with money, although she does challenge the fees that Lissner has billed.

“I have been trying to free my father because of my love for him,” Libra tells Rolling Stone, “and because he has been subjected to such cruelty,” she adds, referring to his alleged isolation from family and friends.

Full Article and Source:
Pop-Art Icon Peter Max’s Daughter Files New Suit Calling His Guardianship ‘Inhumane’

Guardianship Profile: John Robertson (Michigan)

In 2014, my father, John Robertson, was diagnosed with Dementia and Alzheimer’s.

He was appointed a guardian by the court through a private agency. The court nor the other agency took the time to find relatives or find out about my father’s properties or assets. The property taxes were not paid on a vacation property near Houghton Lake, so this property was lost in a tax auction in 2015.

Also, in 2015 the court granted guardianship to a person my father did not like. He was acquainted with my father’s now deceased second wife.

It has come to pass that some how the guardian was able to take my father’s pension and social security from his bank. I was told by the court that all he had control over was medical decisions and where my father lived. From what I’ve learned from neighbors, his home was in disrepair. Every room leaked water and each had pails to catch the water. Also mold was all over the house, and the cooking stove was not working properly.

I was told by friends and neighbors that he was left to fend for himself, even though he had dementia and Alzheimer's. My father’s hard earned money was not put back into the property, nor were the taxes or utilities paid. The guardian did the least possible to ensure my father had a good living habitat.

NASGA: John Robertson - MI

Monday, June 13, 2022

Know Your Rights

If you are in guardianship/conservatorship litigation, or about to enter litigation, the first thing to do is read and devour the guardianship and conservatorship laws of your state.* You may think it’s your attorney’s job to know, advise, and take care of you. After all, that’s what you’re paying dearly for.

But here’s the reality: attorneys get paid whether they win or lose your case. Most want to win, of course, because of dedication, compassion, pride, or ego. But, if you lose, you still pay your attorney. You both go to the bank – you to make a withdrawal, your attorney to make a deposit!

And attorneys make mega bucks by taking on lots of cases. They juggle their expanding caseload and give minimal attention to the cases in the forefront, saving maximum attention for litigation. To you, there is only one case in the world; to your attorney, you’re one of many in the stack.

Because it’s your case, and because guardianship/conservatorship many times involves life and death, it’s to your advantage to know as much about guardianship/conservatorship law as your attorney. All guardianships, for instance, by law must contain certain aspects of due process, including notice to the AIP (alleged incompetent person), a hearing to determine incompetency, etc. If you know there was no incompetency hearing in your case, as an example, then you’ve got something to shout about! A jurisdictional issue can have the whole case thrown out of court and end your nightmare!

So, don’t totally count solely on your attorney. Count on you!

Not all attorneys are bad. Many or most take pride in their profession and pour their heart and soul into their caseload. Still, many attorneys are members of the “good old boy’s club” or “incest club.” Sometimes, they work for the guardian – sometimes they work for you. Sometimes they work for each other by trading or referring clients. If you familiarize yourself with the state statutes, and your attorney feeds you a line, you’ll taste baloney instead of the condiments.

If your don’t know your rights, consider you’re standing in front of this tank!

Source:  NASGA: Know Your Rights!

RI General Assembly Approves to Lower the Elder Financial Exploitation Age

The General Assembly approved a bill Thursday that would lower the age of eligibility for a Rhode Islander to be considered a victim in elder financial exploitation.

Currently, Rhode Islanders are required to report elderly exploitation for anyone 60 or older, however, a person can’t be charged unless the victim is at least 65.

If passed, the bill will lower that age to 60.

Senator Cynthia Armour Coyne, who helped fight against elderly financial exploitation from 2018 to 2019, wants to help protect residents.

Full Article and Source:
General Assembly Approves to Lower the Elder Financial Exploitation Age

Sunday, June 12, 2022

Two members of Santa Rosa County Sheriff's Office charged with elderly exploitation

by WEAR staff
SANTA ROSA COUNTY, Fla. -- Two members of the Santa Rosa County Sheriff's Office have been arrested for elderly exploitation, the sheriff's office announced Friday.

Deputy Carl Scheel III and Civilian Clerk Alicia Scheel -- husband and wife -- were arrested Friday and charged with one felony count of exploitation of the elderly for more than $10K but less than $50K. The alleged crimes took place between Feb. 6 and June 8, according to the report. 

"Accountability and professionalism are important traits to be a member of the Santa Rosa County Sheriff’s Office," the sheriff's office says in a release. "We work hard to earn and maintain our community support. Sheriff Johnson is adamant that no one is above the law, that includes our own employees."

The release states Santa Rosa County Sheriff’s investigators recently concluded a month-long domestic investigation, which led to the arrests.

According to the report, Carl Scheel III and Alicia Scheel moved a pickup truck from Carl's father's name into their names without the father's consent. They also allegedly moved some of the father's money into their names with his consent.

"When you become the legal guardian of somebody -- especially an elderly person -- and you become a fiduciary, that basically means you have to do everything in the interest of that person," Sheriff Bob Johnson said. "But they didn’t take that to heart ...They ended up getting money from him and a vehicle from him in an illegal manner."

Both members were separated from their employment and charged accordingly, according to the sheriff's office.

Both posted bond and were not taken to the Santa Rosa County Jail.

“Agency employees will always be held to high standards, both on and off duty," Sheriff Johnson said in a release. "Although an arrest has been made, we are continuing this investigation and it remains very active."

Full Article & Source:

North Dakota justices disciplined a Fargo judge candidate. He says he learned from the experience.

Blake Hankey represented a defendant and accuser in a case, a conflict that a prosecutor said he lied about. Hankey disputed claims that he made "false statements" in the case.
Blake Hankey.Forum News Service photo

By April Baumgarten

FARGO — A candidate for a judge post in Fargo once faced disciplinary action for representing both the victim and the alleged perpetrator in an assault and terrorizing case — a conflict that a prosecutor said he lied about.

However, the candidate for judge, Blake Hankey, disputed that he lied about the situation.

Hankey, a lawyer who wants to take over for East Central District Judge Steven Marquart , was reprimanded in 2012 by the North Dakota Disciplinary Board and state Supreme Court. He was ordered to pay $7,160 for the disciplinary proceeding costs.

The action came after Meredith Larson, a Grand Forks County prosecutor at the time, filed a complaint against Hankey.

According to the North Dakota Supreme Court ruling:

Hankey represented a defendant and an accuser in a 2011 case in which the defendant was accused of aggravated assault and terrorizing. Hankey did not tell Larson he was representing the two clients. When confronted about it, Hankey “falsely told (Larson) that he had cleared any conflict with his law partners,” the ruling said.

A hearing panel of the North Dakota Disciplinary Board found Hankey violated attorney rules surrounding conflicts of interest, meaning he should not have represented both clients. However, the panel found his “false statement” did not violate rules of conduct since it didn’t benefit him. The panel also ruled he didn’t have to tell Larson that he was representing the accuser in the case.

The state Supreme Court said in its ruling Hankey violated ethical rules when he made the “false statement,” ultimately reversing the hearing panel's decision on that matter.

Larson was unavailable for comment Thursday, June 9.

Hankey, who also is mayor of Harwood, North Dakota, acknowledged the incident in a recent interview with The Forum. The attorney of nearly 20 years said he has learned from it.

“I figured this would come up and I've accepted it,” he said.

Hankey explained that the victim in the case, the girlfriend of the man accused, asked Hankey to represent her boyfriend. The woman told Hankey she lied to police and asked if he would represent her if the charges against her boyfriend were dismissed, Hankey said.

“So it wasn't going to be at the same time,” he said. “It was going to kind of be an either-or.”

Hankey said he cleared the representation of the two clients with one of his partners and had the clients sign conflict-of-interest waivers.

The woman also faced eviction, so Hankey drafted a letter for her regarding that and a collections matter, he said.

Hankey said he told Larson he didn’t represent the woman in the criminal matter but acknowledged representing the woman in civil cases.

Hankey disputed claims he lied about checking with his partner to determine whether he could represent the two clients. He said he cleared it with his most senior management partner, but not both.

“I think that is really important,” he said. “It makes it sound like I just blatantly lied to her and I made this up when I had cleared it with our most senior partner.”

Hankey eventually withdrew from the case and refunded his retainer to the two clients. He also said he complied with the process.

“There were no bad intentions going into this,” he said.

The two clients said they were happy with Hankey’s services and that he did not cause them injury, according to the hearing panel's transcripts and the state Supreme Court's ruling. The defendant said Hankey did the best he could under the circumstances, according to the transcripts.

Hankey called the incident isolated, noting he hasn't faced disciplinary action since.

Hankey has practiced in a wide variety of areas, including criminal defense, family law and personal injury. He said he is dedicated to his community, adding that being a judge is his dream job.

“I'll work harder than anybody else," he said. "I will do everything and anything I can in my power to be the absolute best judge that I can be.”

Marquart announced earlier this year he would not seek reelection. Hankey is running against attorneys Jay Greenwood, David Chapman and Connie Cleveland. The Forum found no records of attorney discipline for Greenwood, Chapman and Cleveland in North Dakota.

The top two vote-getters in Tuesday's primary election will move on to the general election in November.

If elected judge, Hankey would have to step down as mayor of Harwood.

Full Article & Source:

Medicaid weighs attaching strings to nursing home payments to improve patient care

by Susan Jaffe

Craig F. Walker—The Boston Globe/Getty Images

The Biden administration is considering a requirement that the nation’s 15,500 nursing homes spend most of their payments from Medicaid on direct care for residents and limit the amount that is used for operations, maintenance, and capital improvements or diverted to profits.

If adopted, it would be the first time the federal government insists that nursing homes devote the majority of Medicaid dollars to caring for residents.

The strategy, which has not yet been formally proposed, is among several steps officials are considering after the COVID-19 pandemic hit vulnerable nursing home residents especially hard. During the first 12 months of the pandemic, at least 34% of the people killed by the virus lived in nursing homes and other long-term care facilities even though residents of those facilities make up fewer than 1% of the U.S. population.

Medicaid, the federal-state health insurance program for low-income people, pays the bills for 62% of long-term care residents in nursing homes. In 2019, that totaled $50.8 billion. Medicare, which covers short-term nursing home visits for older adults or people with disabilities, spent $38.2 billion that year. (Officials have not included Medicare payments in their discussions of a direct care spending mandate.)

“The absolutely critical ingredient” for good care is sufficient staffing, Dan Tsai, a deputy administrator at the Centers for Medicare & Medicaid Services and Medicaid director, told KHN.

CMS requested public comments on a possible direct care spending mandate in its proposed update of nursing home payment policies and rates for next year. Tsai also spoke about it at a meeting with Illinois state officials, nursing home workers, residents, and relatives in Chicago in April.

Studies have found a strong connection between staffing levels and care. CMS doesn’t require specific numbers of nurses and other staff members, although some states do.

“We want to make sure that the dollars get to the direct care workforce to ensure high-quality care,” Tsai told KHN.

To receive a government paycheck, nursing homes must follow dozens of requirements aimed at ensuring high-quality care. They can be penalized for violations. But federal investigations have found that inspectors can miss serious problems and that inspections don’t consistently meet CMS standards. Infection control has been one of the most common violations.

In its request for public comment, CMS asked several questions, including: “Is there evidence that resources that could be spent on staffing are instead being used on expenses that are not necessary to quality patient care?”

The federal interest follows laws enacted in three states—Massachusetts, New Jersey, and New York—to mandate spending on care. Massachusetts requires nursing homes to spend at least 75% of revenue on residents’ care. New Jersey’s nursing homes must spend at least 90% of Medicaid payments on resident care, and no more than 5% can go to profits. New York mandates that at least 70% of nursing home revenue—including payments from Medicaid, Medicare, and private insurance—be used to care for residents and that at least 40% of the money for direct care pay for “resident-facing” staff. Profits are capped at 5%. All three states promise a boost in state Medicaid payments to facilities that comply with the laws.

In April, the National Academies of Sciences, Engineering, and Medicine endorsed the direct care spending strategy in a report about improving nursing home care.

“When you’re taking public dollars, those dollars should be put back into direct care,” said David Grabowski, a professor of health care policy at Harvard Medical School and a member of the committee that wrote the report. “We’re expecting that the nursing home will make the best judgment as to the right kind of share of spending on labor and materials and capital to really produce the highest level of quality, but that just hasn’t been the case. So this recommendation is really an opportunity to put up some guardrails.”

National nursing home industry groups oppose such requirements. And in New York, two trade associations and about half the state’s homes have filed two lawsuits to block the state’s spending directive.

Staffing is already “the No. 1 expense” for nursing homes, said Stephen Hanse, president and CEO of the New York State Health Facilities Association, which represents 350 nursing homes and spearheaded one of the lawsuits. “We’re a hands-on industry.”

The 239 nursing homes that joined the association’s lawsuit claim that if New York’s law had been in effect in 2019, the facilities would have been forced to provide residents with an additional $824 million in direct care or return that amount to the state.

Hanse objects to the state’s telling nursing home administrators how to do their jobs. “You can have an amazing dietary program, for example, and this law would mandate that you lay off dietary workers and hire front-line workers to meet the staffing requirement,” he said.

Groups bringing the lawsuits argue that forcing owners to spend more money on direct care leaves less money for maintaining their facilities and that the quality of care will suffer. They also claim Medicaid doesn’t cover the cost of caring for residents. Advocates for residents say facilities can hide their profits by overpaying related businesses they own, such as laundry or food-service companies.

Although a spending mandate is new for nursing homes in the three states, it has become routine for health insurers nationwide. Under the Affordable Care Act’s “medical loss ratio” provision, health insurance companies must spend at least 80% of premiums on beneficiaries’ medical care. A maximum of 20% can be spent on administrative costs, executive salaries, advertising, and profits. Companies that exceed the limit must refund the difference to beneficiaries.

In addition to a direct care spending mandate, Tsai said CMS is interested in a slightly different approach underway in Illinois, which made changes to nursing home regulations this year. Its nursing home rate reform law raises Medicaid funding and then requires each home to hire at least 70% of the staff that the state’s analysis shows the residents need. The state then uses payroll and other data to verify that the facility complied. If not, the difference will be deducted from its next payment.

“There are states across the country trying a range of approaches to make sure that dollars in the system from nursing facility reimbursement rates are actually—one way or another—getting to sufficient, high-quality staffing,” Tsai said. “That's our primary goal.”

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