Caretaker ‘preyed’ on home care residents left begging for food, Georgia officials say

By Tanasia Kenney

An Atlanta woman gets a 20-year sentence after she’s accused of neglecting disabled and older adults living in her unlicensed personal care home in Georgia, state authorities said. Getty Images/iStockphoto

Residents of a home care facility were promised “housing, meals and other services,” but were instead left without cash and begging for food, according to the Georgia Attorney General’s Office. 

Now, an Atlanta woman is headed to prison. 

Michelle Oliver was given a 20-year sentence, with the first seven years to be served in prison, after she was convicted Sept. 8 on charges related to the neglect of older, disabled adults living in an unlicensed personal care home she owned, state authorities said.

A Dougherty County jury found her guilty on multiple charges including willful deprivation of an elder person and 51 counts of financial exploitation of a disabled adult, according to a news release.

 Investigators said Oliver, who owned the Miracle One Care Center, also pocketed more than $32,000 from residents between December 2016 and September 2017, all while still depriving them of basic needs. An investigation found residents were often left alone in filthy homes with no furniture, air conditioning or access to clean clothes.

“Michelle Oliver preyed upon some of our state’s most vulnerable and in-need citizens,” Attorney General Chris Carr said in a statement. “She systematically neglected those she had promised to help, all while taking their money but leaving them with nothing in return.” 

In December 2016, Oliver moved several residents from the Atlanta area into “a series of duplexes” nearly 200 miles away in Albany, according to authorities. The Georgia Department of Human Services, along with the Georgia Bureau of Investigation and other state agencies, launched an investigation after a complaint from a concerned citizen about the Albany facility. 

In addition to the dirty conditions, investigators said residents were deprived of food despite Oliver hiring a “cook” who prepared meals in the morning “but left before the lunch hour.”

“Due to the residents’ disabilities, they did not have access to their own money and were left to beg neighbors and nearby stores for food on a near daily basis,” state authorities said. 

A financial payee who took residents’ monthly payments pleaded guilty to charges in the case last year, according to the attorney general’s office. 

The residents were eventually moved out of the duplexes, many of which the Albany Code Enforcement deemed “unfit for human occupation,” authorities said.

Albany is about 90 miles southeast of Columbus.

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Caretaker ‘preyed’ on home care residents left begging for food, Georgia officials say

DSS reports increase in severity of neglect cases among disabled adult, elderly population

Carteret County Department of Social Services Adult Protective Services Supervisor Zack Dixon works on one of the many disabled adult abuse cases his office has seen during the coronavirus pandemic. (Cheryl Burke photo)

by CHERYL BURKE

BEAUFORT — Carteret County Department of Social Service workers are seeing the effects of the coronavirus pandemic on families, especially on disabled adults and the elderly.

“We’ve seen an increase in the severity of the neglect cases,” DSS Adult Protective Services Supervisor Zack Dixon said Thursday. “Prior to COVID, people were out and about and there was more of a support system for the disabled and the elderly. With COVID and everyone self-isolating, the safety and support has dried up.

“No one is checking in with some of these individuals to make sure they are OK,” he continued.

Because of that, Mr. Dixon said by the time DSS workers are called out to check on individuals, the neglect is extreme.

“No one has been checking to see if these individuals have been out of food, if their lights were cut off or with dementia cases, if they’ve been bathing and cleaning themselves,” he continued. “We’ve found people who were severely emaciated and people living in conditions that were deplorable and unlivable.”

He added that as well as negative physical effects, workers are seeing an increase in mental health issues connected to long-term isolation.

“Depression and anxiety are on a major uptick,” he said. “Isolation is doing much more harm than just physical on the elderly population.”

Mr. Dixon appealed to the community to check on their elderly and disabled adult neighbors to make sure they are safe and check if in need of assistance.

“Even if it’s just making a phone call, you can tell a lot by talking with someone on the phone,” Mr. Dixon said.

DSS Director Clint Lewis added that it’s also good to stop by and check on the individuals.

“It may be just seeing if they need food,” he said.

The APS division handles victims of abuse, neglect and exploitation among the disabled adult and elderly population. Once a suspected APS report is filed, workers investigate the situation and work to provide a healthy and safe environment for the individual.

From July 2019 through June 2020, APS received 236 reports of suspected abuse, neglect and exploitation among the disabled and elderly in Carteret County. This July, APS received 29 reports.

While case workers try to rectify the situation by working with family members, sometimes that is not possible. If it’s determined the person can’t take care of themselves and there are no other options for their health and safety, Mr. Lewis said the individual will become a ward of the state.

“If it’s determined they don’t have the capacity to take care of themselves, and there is no family to help, and they are deemed incompetent, a guardian is appointed and DSS is appointed a third party guardian,” Mr. Lewis said. “It becomes our responsibility to ensure their health and safety.”

Adult Guardian Supervisor Patti Sigmon said DSS has seen an increase in the number of disabled adults in the county becoming wards of the state.

“We normally average between 66 and 68 wards. Right now we have 74 and we have four scheduled court cases that are so bad that I don’t think there is anything else to do but take over. I think we’ll be up to 80 wards by the end of the year.”

Ms. Sigmon said the majority of those who become wards are placed in adult assisted living facilities or group homes. Because of limited space in the county, many are placed in facilities elsewhere.

Those suspecting a disabled adult or elderly person is being neglected, abused or exploited can contact DSS at 252-728-3181.

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DSS reports increase in severity of neglect cases among disabled adult, elderly population

Illinois Estate Guardians Receive a New Job: Guardianship Estate Planning No Longer Optional?

When guardianship estate planning entered Illinois law in 1996, it was viewed as an optional benefit available to guardians to give disabled adults the tax savings available to abled people. That may be changing.

In In re Estate of Rivera, the Appellate Court of Illinois addressed the process as part of a duty possessed by guardians of the estate of disabled adults. Estate guardians may now be required to petition the court to enact new estate plans – or modify existing plans – on behalf of their wards to include only those individuals whom the estate guardian has reason to believe the ward would choose to include if the ward was not under disability. The “best interests” standard that governs 755 ILCS 5/11a-18(a-5), has been interpreted in Rivera as not only allowing deviation from intestacy in such plans, but perhaps even requiring it where the facts are compelling. Compelling facts likely include cutting out intestate heirs with no relationship or poor relationships with the disabled person. Compliance with this duty appears to impose a substantial burden on estate guardians.

IN DEPTH

Background

The Illinois guardianship estate planning statute, 755 ILCS 5/11a-18(a-5), allows the guardian of the estate of a disabled adult to establish estate plans for their ward on petition to the court. Historically, most estate guardians followed the rules of intestacy in implementing these estate plans. However, in 2015, the Appellate Court of Illinois, First District held Section 5/11-18 statutorily empowers an estate guardian to petition a court to enact an estate plan that deviates from the rules of intestacy. Estate of Howell v. Howell, 2015 IL App (1st) 133247, ¶ 41, 36 N.E.3d 293.

The court in Howell held that an estate guardian may petition the court to enact an estate plan that includes only those persons whom the guardian believes the ward would choose to include as beneficiaries because Section 11a-18(a) provides that the estate guardian shall apply the income and principal of the estate “for any other purpose which the court deems to be for the best interests of the ward, and the court may approve the making on behalf of the ward of such agreements as the court determines to be for the ward’s best interests.” The court in Howell concluded that it is in a ward’s best interests for the estate guardian to petition the court to enact an estate plan that disinherits a ward’s family members if the estate guardian has reason to believe that the ward would not wish for those family members to benefit from his or her death. The court in Howell also found that, in the event an estate guardian files such a petition, the court should conduct an evidentiary hearing to determine the ward’s “best interests” before granting the petition and enacting the plan.

The Rivera Decision

While Howell provided an estate guardian with the ability to take such action, the recent decision in Rivera has turned that ability into an obligation to consider taking such actions, particularly where heirship exclusions seem justified. In re Estate of Rivera, 2018 IL App (1st) 171214.

The ward in Rivera, Inez Rivera, had never had testamentary capacity. In 2015, Inez’s estate guardian petitioned for and received authority to enact an estate plan for Inez. Since Howell was pending at this time, the guardian’s proposed estate plan followed the rules of intestacy.

After Howell was decided, the estate guardian petitioned the court to amend Inez’s estate plan to benefit only Inez’s mother, who was the guardian of her person; Inez’s full sister; and Inez’s three half-sisters who lived with Inez. The estate guardian, after consulting with Inez’s mother, had reason to believe that Inez would only choose to benefit those individuals. Other facts about Inez’s relationship to her father suggested that she would have cut him out if she could.

After conducting an evidentiary hearing on Inez’s best interests, the court granted the estate guardian’s petition over the objection of Inez’s father and eight of Inez’s other half-siblings. In particular, the court found that Inez’s mother cared for Inez exclusively from the time of Inez’s birth. Conversely, Inez’s father had never lived with Inez, had never cared for Inez, had been violent to Inez’s mother, and had fathered eight other children with other women besides Inez’s mother. Inez’s half-siblings who were children of her father did not have any relationship with Inez either.
On appeal, the Court held that:

“A ward’s best interests are not fixed and it would be unsound to conclude that a ward’s estate plan should be unmodifiable, particularly in this case where the ward is a young adult and her best interests may change over her lifetime. We find that an estate guardian is empowered and obligated by the Probate Act to amend a disabled ward’s estate plan when material circumstances change and an existing plan, whether it be an original or amended version, is no longer in the ward’s bests interests due to a change in circumstances.”

In re Estate of Rivera, 2018 IL App (1st) 171214, ¶ 55 (emphasis added).

The Result

As a result of this holding in Rivera, guardians of the estate in Illinois should consider, in each case, whether compelling facts about family relationships dictate a need to compose a plan and offer it to the court for a hearing. If an estate guardian has reason to believe the ward’s plan should be implemented or modified to exclude any family members, the estate guardian should petition the court to establish or amend the plan.

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Illinois Estate Guardians Receive a New Job: Guardianship Estate Planning No Longer Optional?

DISABLED ADULTS FEEL MEDICAID PINCH

Sue Schnars braids daughter Ivana's hair

Since 43-year-old Ivana Schnars moved into a nursing home in Pflugerville, her mom, Sue Schnars, has tried to make it as comfortable as the home where her daughter spent most of her life. Citrus essential oil perfumes the dorm like room. Relatives have left sweet messages on a white board. Pink decorations dot the walls.

Unable to care for Ivana Schnars, who is nonverbal and uses a wheelchair, on her own, Sue Schnars moved her out of their North Austin home in August.

Schnars had trouble finding and keeping caregivers for Ivana. With the state’s Medicaid reimbursement, she could pay personal attendants only $11 an hour without benefits.

“I agonized over this decision,” Schnars said. “She’s my daughter, and I love her. For 43 years, I kept her home. For 43 years, I was able to make sure she was safe and clean and that she had everything that she needed. People at the retirement home are wonderful, but they’re not me.”

Schnars is using her daughter’s Social Security income to pay for the nursing home.

The turnover rate among attendants is high across the country — 45 to 65 percent — but stagnant pay rates in Texas have worsened the problem here. Attendants in Texas are paid on average $9.30 an hour, while the nationwide average is $11.59, according to an August report by the Texas Health and Human Services Commission.

For nearly a decade, the state has not increased the payment rates of personal attendants in Community Living Assistance and Support Services, the Medicaid program that covered care for Ivana Schnars and 5,600 other Texans. The state sets the attendant rate in the program at about $13 an hour, but after administrative fees and payroll taxes are shaved off, the rate families can pay attendants is lower.

Additionally, the state cut the attendant rates of two other Medicaid programs for individuals with disabilities — Texas Home Living and Home and Community-based Services — by 21 percent last year to $17.73 an hour to align the rates with other Medicaid programs. The decision affected caregivers for about 8,000 people in both programs. Dozens of people with disabilities and their relatives had pleaded with the agency in a meeting last year to reconsider the cuts.

The cuts saved the state $26.6 million over a two-year period. Texas Home Living, which providers say has long been a financially difficult program to run, has been hardest hit by the cuts—19 providers have terminated contracts.

“On a business level, you can’t do something where every month you’re not paying your bills and you have to borrow from one program to pay for another program,” said Doug Svien of the Company Rock House, a Stephenville provider group that has stopped participating in the Texas Home Living program. “Maybe somebody out there that can do it for less cost than I can do it, and God bless them.”

Texas Health and Human Services Commission officials said they’re working on improving retention and recruitment in Texas, including asking the Legislature to raise the pay for attendants. The agency estimates that it will spend $7.9 billion on community attendant services during the 2020-21 budget.

“We know long-term care providers in Texas have indicated they are facing difficulties recruiting and retaining the qualified community attendants needed to provide care. We are working to better capture data on attendant turnover and retention, which can be used to help determine effective strategies for improvement,” a statement from the agency said.

‘A really hard decision’

Ivana Schnars was born in Peru, where her parents were social workers in the 1970s. She was developing normally until a vims attacked her brain, leading to cerebral palsy.

Sue Schnars, who recently retired from her job as a special education administrator for the Pflugerville school district, had for years relied on attendants to feed her daughter, read to her, change her clothes and take her on outings, among other activities. More recently, she relied on them the most to help carry her, something the 61-year-old can no longer do.

Amy Gayer -Byles, Ivana Schnars’ caregiver for seven years, struggled to make ends meet. A part-time Austin Community College student saddled with a car note, Gayer Byles would forgo doctors’ appointments and often not use electricity in her apartment and skip meals to pay her bills. Although she loved Schnars — it’s evident by a scrapbook she made of their time together that now sits in Schnars’ room at the nursing home — Gayer-Byles needed to support a family, so she quit.

“That was a really hard decision,” Gayer-Byles said.

“There’s no other words,” Gayer-Byles said through tears. “You’re talking about real people. These are families. They’re struggling to live a day-to-day life, and more and more hurdles are being put in front of them. It’s just unbelievable.”

After Gayer-Byles left three years ago, four caregivers followed. One couldn’t live on $11 an hour. Another would bring her personal drama to work, Sue Schnars said.

“I had taken out ads through Care.com. I did Craigslist,” Sue Schnars said. “There were plenty of people who responded to my ads, but when I told them how much I could pay, they were like, no way. And the responses always were, ‘I can’t rent an apartment and live in Austin for 11 dollars an hour.’” Texas has the second-highest number of personal attendants — 196,790, according to a report by the Texas health agency. Personal attendants will continue to be in high demand across the country because of an aging population and lowpay that has led to high turnover, according to the U.S. Bureau of Labor Statistics.

According to an email Schnars received from the Texas Health and Human Services Commission, an official said: “You are not the first person reporting this issue. Austin seems to have its extra challenges with the relatively high cost of living, but rural areas seem to have staffing issues as well.”

QT Preston makes $12 an hour working part-time as an attendant, reduced by $1 as a result of recent state cuts, she said.

Preston, who also works as a behavioral therapist, said it would be impossible to live off that wage in Austin without juggling another job.

“Attendants should be paid way more because there is such a need in these individuals’ lives. They help the family as a whole because they give parents a much-needed break and an overall improvement of life for everyone involved,” Preston said. “A role of an attendant has been downplayed.”

Austin resident Jane Ayala, 72, makes $9 an hour working 14 hours a week with a disabled adult client who is on a Medicaid waiver program.

She takes her client to work at Chuck E. Cheese’s three days a week, picks her up, has lunch with her and takes her to activities. Aprivate agency pays Ayala $9 an hour.

“It probably covers gas and to have lunch with her, ” Ayala said of her pay. “I just love people, and I know that they need a break.”

‘Chasing nickels’

The state offers Medicaid services to people with disabilities through waiver programs. Home and Community-based Services and Texas Home Living programs serve people with more severe intellectual disabilities than the Community Living Assistance and Support Services program.

Personal attendant services covered through these Medicaid programs are meant to keep people with disabilities in their own homes, where they can either learn to be independent or rely on family to help them.

Staying at home not only is preferred for the well-being of the individual but also is less expensive for the state than paying to live in a group home or some other facility.

When the state proposed the rate cuts in 2017, about 50 people showed up to a hearing to protest the cuts. They said the cuts would force attendants to find jobs in retail and fast -food restaurants that pay comparably but require fewer skills. They said the state’s most vulnerable people would be in danger because their families would be forced to turn to low-quality attendants.

Employers of these attendants said there is a chronic shortage of staff.

“In the Central Texas area, you can work at Whataburger and get a rate higher than what some are receiving as far as salaries. When we try to find persons we can afford, it’s very difficult to find the quality that we’re looking for for the families we serve,” said Andrea Richardson, executive director of Round Rock-based Bluebonnet Trails Community Services. Bluebonnet Trails also was affected by the cuts.

Daybreak, a large provider, this year ended all but one of its Texas Home Living contracts, according to the state health agency.

“Before this rate reduction happened, providers had already been dropping out of Texas Home Living because rates had been slashed so many times already. This latest one was the icing on the cake,” said Sandy Frizzell Batton, executive director with the advocacy group Providers Alliance for Community Services of Texas.

Robert Ham with D&S Community Services, which operates in Austin as well as cities in other parts of Texas, Tennessee and Kentucky, said participating in Texas Home Living is a financial wash for him. Similar employees at state-supported living centers for people with disabilities make 40 to 60 percent more, he said.

“I’ve been in this business because it’s my passion to provide these services,” Ham said. “It’s always looked at as the state is just giving providers more money. It’s not that way. We’re chasing nickels. ” State health agency officials had dropped the rates in preparation for shifting these Medicaid waiver programs into managed care, part of a massive transition of Medicaid services mandated by the Legislature. Under managed care, the state contracts with private insurance companies and hospitals to administer services, saving the state money; critics of the model say the private companies, called managed care organizations, have denied care for people to save money.

A Medicaid program for children with disabilities has for the past few years been under managed care, and over that time, hundreds of parents have complained about the managed care organizations unjustly denying critical services for their vulnerable children.

The Health and Human Services Commission is required to release a report annually on the status of personal attendant services in the state as well as recommendations on how to improve retention and decrease turnover. The agency’s August report to the Legislative Budget Board and to the governor’s office recommended increasing the wages of attendants, as well as improving recruitment through local workforce development; creating a state workforce development plan to improve retention and recruitment of attendants; requiring employers of attendants to provide attendants with information about a federal program that offers low-cost child care; increasing training for attendants to improve job satisfaction; and allowing attendants to live with their clients so that family members can become attendants and be paid an attendant wage.

“I agonized over this decision. She’s my daughter, and I love her. For 43 years, I kept her home. For 43 years, I was able to make sure she was safe and clean and that she had everything that she needed. People at the retirement home are wonderful, but they’re not me.”
 
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DISABLED ADULTS FEEL MEDICAID PINCH

DHS sends letters to seniors, disabled adults notifying of home-care program elimination

"We sincerely regret this action," the letter states. "Should the state Legislature act to restore funding for the ADvantage Waiver before December 1, 2017, DHS will notify you as quickly as possible. "

The Oklahoma Department of Human Services lost $69 million of its

budget due to a state budget shortfall. DYLAN GOFORTH/The Frontier

A program that provides home-based care to seniors and disabled adults will end Nov. 30, according to a letter sent to the program’s participants.

The Oklahoma Department of Human Services sent letters out to ADvantage participants on Tuesday, notifying them the program would be eliminated Nov. 30.

“We regret to inform you DHS must eliminate the ADvantage Waiver effective December 1, 2017,” the letter states. “Your participation in the ADvantage Waiver will be funded until November 30, 2017. Since elimination of the ADvantage Waiver affects everyone receiving services through it, there is no right to appeal this action.”

DHS sent a letter on Tuesday announcing the ADvantange program’s 

elimination. Courtesy

The ADvantage Waiver Program is designed to help seniors and adults with disabilities live at home, rather than in a nursing home or a similar type of adult care.

DHS reported the program serves more than 21,000 people and the loss will impact about 450 providers.

The agency estimated when the program is eliminated, about 10,000 of those served will be forced into nursing homes. DHS noted the state doesn’t have enough nursing homes to accommodate those people.

DHS lost $69 million of its state funding for Fiscal Year 2018. Last week, the agency submitted a revised budget to the Oklahoma Office of Management and Enterprise Services.

The revised budget included eliminations of DHS services, including the ADvantage program. It also would eliminate funding for adult day services for seniors and adults with disabilities and in-home services for seniors, including home-delivered meals and home-making services.

DHS spokesman Jeff Wagner said the agency will send additional letters to participants by Nov. 20 to tell them whether they are eligible for regular Medicaid benefits. If they are, they likely qualify for nursing-home care, he said.

“We sincerely regret this action,” the letter states. “Should the state Legislature act to restore funding for the ADvantage Waiver before December 1, 2017, DHS will notify you as quickly as possible. ”

On Monday, state lawmakers agreed to pull more than $100 million from the state’s Rainy Day Fund, to be sent to the Department of Humans Services, Oklahoma Health Care Authority and the Department of Mental Health and Substance Abuse Services. However, that would not fill the state’s $215 million budget shortfall.

DHS would receive about $29 million of the $69 million lost.

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DHS sends letters to seniors, disabled adults notifying of home-care program elimination

Bill targets ‘license to steal’ from elderly, disabled adults

Dan Goerke, State Rep. Chuck Efstration & Vernon Keenan

ATLANTA - The director of the GBI says a legal maneuver is being used as a “license to steal” from vulnerable Georgians, and he’s looking for passage of a bill in the state Legislature to change that.

“We want to stop the elderly and disabled adults having their assets stolen by family members and others who get that power of attorney,” Vernon Keenan said at the state Capitol on Tuesday. “When … they steal all the assets and they’re confronted by law enforcement, they pull out that power of attorney and wave it around like it’s their defense.”

A power of attorney is a document that someone signs to grant a trusted friend, family member or other agent to act on their behalf. Many people sign one for medical reasons, such as an Alzheimer’s disease diagnosis.

Keenan was speaking at a news conference on House Bill 221. If it passes, Keenan said, his office would train law enforcement and prosecutors to go after such fraud under the new law. State Rep. Chuck Efstration, author of the bill, filed a similar bill last year.

“I think an important aspect of the testimony we’ve heard is that there’s not a specific mention in the elder abuse statute for these types of crimes, and the danger is that law enforcement responding to reports of these offenses are in a position, or an argument is made, that this is a civil matter, (that) this isn’t a criminal matter,” Efstration said.

He said his bill makes it clear that abusing a power of attorney is a crime that should be investigated and prosecuted.

He also said the measure will make it clear that the agent — the person who has the power — must act in the best interest of the person who has signed over those powers.

Efstration said his bill would bring Georgia’s law into line with 21 other states that have enacted uniform power-of-attorney laws.

“That will provide for a form that users of this power of attorney can easily find in the law and utilize,” the Dacula Republican said.

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Bill targets ‘license to steal’ from elderly, disabled adults