'Frequent flyer' Judge Bruce Morrow gets a break in sexual taunting case

by Tresa Baldas

In the end, Judge Bruce Morrow got a break.

The twice-disciplined judge got to keep his job after the Michigan Supreme Court on Thursday suspended him without pay for six months for making crass and sexual comments in court — behavior that could have gotten him removed from the bench.

The Judicial Tenure Commission had recommended a 12-month suspension — which would have ended Morrow's judicial career in Wayne County Circuit Court — concluding he committed judicial misconduct when he sexually taunted female prosecutors during a 2019 murder trial.

According to the JTC complaint, Morrow's misconduct included: talking about the "climax of sex" with one prosecutor; using an F-bomb to describe sex; mocking the defendant over the size of his penis in chambers; asking a prosecutor during a trial break, "Would you want foreplay before or after sex?"; and asking a prosecutor her height and weight.

In the end, Judge Bruce Morrow got a break.

The twice-disciplined judge got to keep his job after the Michigan Supreme Court on Thursday suspended him without pay for six months for making crass and sexual comments in court — behavior that could have gotten him removed from the bench.

The Judicial Tenure Commission had recommended a 12-month suspension — which would have ended Morrow's judicial career in Wayne County Circuit Court — concluding he committed judicial misconduct when he sexually taunted female prosecutors during a 2019 murder trial.

According to the JTC complaint, Morrow's misconduct included: talking about the "climax of sex" with one prosecutor; using an F-bomb to describe sex; mocking the defendant over the size of his penis in chambers; asking a prosecutor during a trial break, "Would you want foreplay before or after sex?"; and asking a prosecutor her height and weight.

"Bruce Morrow used sex in a few analogies, just as other lawyers, judges and legal scholars have done,"  Donald Campbell,  one of Morrow's lawyers in the case, argued in a court filing. "He also used the word “f ----d” during an in-chambers discussion to describe sex —and one of his listeners was the prosecutor who had just used that word twice in open court and allowed a witness to take the stand with that word on her shirt."

Morrow's lawyer continued: " And he asked two prosecutors about their height and weight, just as he raised a male attorney’s height when talking to a jury about bias.  Those actions were not judicial misconduct. And that is why (the) disciplinary counsel tries to twist the facts to turn Judge Morrow into a sexual predator."

He denied Morrow "hit on" a prosecutor.

"The truth is that Judge Morrow used words that some find distasteful. That is all. And that is not judicial misconduct."

The Michigan Supreme Court disagreed, concluding that Morrow had engaged in judicial misconduct.  But as for punishment, the high court held that a six-month suspension was more appropriate for Morrow "given the severity of (his) conduct relative to that in other judicial discipline cases."

The high court also noted that Morrow's conduct did not affect the rights of the person on trial.

The six-month suspension triggered a blistering dissent from Supreme Court Justice Brian Zahra, who told the disciplinary panel that Morrow is a "frequent flyer" who has "failed" to learn "anything" from his past and should have lost his job.

"This is not the first disciplinary proceeding in which (Morrow's) inappropriate courtroom behavior has been the subject of discipline," Zahra wrote. "Given (Morrow's) history of judicial misconduct, his lack of remorse, and the absence of any assurance that (he) will conform to the rules of judicial conduct in his waning days in office, I strain to find any rational basis to reward (him) with a lesser suspension."

Zahra added: "It is rare for any judge of this state to have been publicly found to have committed judicial misconduct ... (and) to have twice committed misconduct without having resigned or been removed from office."

According to the complaint, here is what led to Morrow’s six-month suspension:

On June 11, 2019, during a break in a homicide trial, an assistant prosecutor asked the judge for feedback on her direct examination of a witness. The judge said he would come down from the bench to talk to her personally "because what he was going to say to her would make her 'blush.' "

Morrow came down from the bench, sat next to the assistant prosecutor, "placed his head very close to her head" and started asking her questions. "So when a man and a woman are close, they start by holding hands, rubbing elbows, kissing, foreplay, then that leads to sex?” 

The judge continued: “You want the foreplay before the sexual intercourse. That’s what we call cuddling. No, you start with holding hands.”

The judge, the complaint said, was making an analogy to the prosecutor to the effect that "the climax of sex is akin to getting the medical examiner to state the cause and manner of death after getting the details of his examination of the body.” 

The judge continued: “You start with all the information from the report, all the testimony crescendos to the cause and manner of death, which is the sex of the testimony.” 

The judge also suggested to the prosecutor that “you want to tease the jury with the details of the examination ... lead them to the climax of the manner and cause of death.”  This discussion caused the prosecutor "to feel 'frozen' and afraid to move," the complaint states.

Then came jury deliberations, and the misbehavior continued.

While the jury deliberated, Morrow invited defense lawyers and prosecutors to join him in chambers, where he chastised a female prosecutor for presenting evidence to the jury that the murder suspect's DNA was found on the victim's vaginal swab.

"All you did was show they f-----!" the judge allegedly told the prosecutor.

Then he "made fun" of the defendant's testimony that he and the victim did not have sex in a normal manner because she was pregnant and he did not want to hurt the baby.

Morrow is also accused of asking female lawyers about their appearance. 

In the 2019 homicide case, for example, the judge allegedly approached the prosecutor's table and asked an assistant prosecutor how tall she was and how much she weighed. He asked the other assistant prosecutor whether she weighed 115 pounds. When she responded with respect to her weight, the judge said, "Well, I haven't assessed your muscle mass yet.'"

This isn't Morrow's first run-in with the disciplinary panel.

In 2014, the Michigan Supreme Court suspended Morrow without pay for 60 days for “continually doing what he wanted regardless of the law.” The JTC had filed a complaint alleging that Morrow had committed misconduct in 10 cases, including many in which he was allegedly overly friendly with defendants. The misconduct claims include: 

• He refused to lock up a convicted child rapist pending sentencing.
• He spared a three-time convicted drunken driver from a mandatory 30-day jail sentence and released him on probation instead.
• He left the bench at the beginning of a trial to shake hands with a defendant and give a package of documents to that defendant's lawyer.
• He improperly closed the courtroom during a hearing and ordered the court reporter not to prepare a transcript.
• He personally retrieved an inmate from lockup, escorting him to the courtroom and sentencing him without restraints or security personnel present. 

Morrow could not be reached for comment.

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'Frequent flyer' Judge Bruce Morrow gets a break in sexual taunting case

S.F. planned to compel more people into drug and mental health treatment. So far, only two have been helped

by J.D. Morris

 

In 2019, San Francisco identified about 4,000 unhoused people who also struggled with addiction and mental illness, many of them deteriorating visibly on the streets.

The tally came not long after the city broadened its rules on who can be forced into court-ordered mental health and drug treatment, a move that could have applied to 50 to 100 people, according to one estimate.

But only two people have been treated by the expanded rules so far.

The anemic numbers reflect the daunting task San Francisco faces as it tries to help thousands of people suffering from the intertwined crises of substance abuse and mental illness.

At stake is the city’s ability to use new legal tools to help some of its most vulnerable residents and confront a public health crisis that has persisted for years.

“We’re failing every single day,” said Supervisor Rafael Mandelman, who has advocated for court-ordered treatment for the most severely ill patients. Mandelman argues mental illness often prevents people from having insight into their disease and therefore from seeking help voluntarily.

Mandelman was hopeful when city officials in June 2019 opted in to a controversial state law that let San Francisco create a pilot program to expand eligibility for those who can be placed into conservatorship, which allows a court to order people into mental health treatment.

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S.F. planned to compel more people into drug and mental health treatment. So far, only two have been helped

AARP Alabama state director: Alabama’s seniors need a modernized guardianship system

by Candi Williams

(Abi Howard/Unsplash, YHN)

It is often a difficult and heartbreaking decision. Someone in your life – usually an aging parent or other loved one – is at the point where they need some help in making vital decisions about matters such as where to live, how to manage their finances, or get the right medical care. While our most vulnerable seniors may need a legal guardian or conservator appointed by the courts, others may only need a more limited approach – one that allows them other less restrictive alternatives to still meet their individual needs.

Unfortunately, Alabama’s current guardianship laws are outdated, relying on a one size fits all, cookie-cutter approach that often robs seniors and people with disabilities of their rights, independence, and dignity. Recent news headlines about guardianship arrangements gone wrong have brought more public attention to this mostly hidden topic.

Alabama’s guardianship laws have not undergone a major revision since the 1980s. Stories of overly restrictive and even abusive use of current guardianship laws are among the many reasons why AARP strongly supports passage of the Uniform Guardianship, Conservatorship and Other Protective Arrangements Act (UGCOPAA) in Alabama. The UGCOPAA would modernize Alabama’s current guardianship laws by addressing several critically needed reforms, including:

• Prohibiting a court from issuing a full guardianship order when a less restrictive alternative is available and appropriate for the individual, such as a supported decision-making arrangement or technological assistance;
• Requiring that each person under guardianship have an individualized plan that considers the person’s preferences and values;
• Clarifying the legal duties of the guardian, including that the guardian must make the best decision for the individual under their care that they reasonably believe the person would make on their own unless doing so would cause harm;
• Clarifying that the guardian must promote self-determination to the extent possible and encourage the individual’s participation in decisions;
• Combating abuse and exploitation by, among other things, forbidding a guardian to restrict communication or visits from family and friends unless the court orders otherwise.

Adopting the UGCOPAA would not only help protect seniors and their rights, it would also support Alabama’s 760,000 family caregivers who make it possible for older parents, spouses, and other loved ones to live independently at home – where they want to be. These family caregivers help with everything from bathing and dressing to meals and transportation. Many also are empowered to make certain legal decisions in various roles such as holding power of attorney, health care proxy, and even serve as guardian or conservator. They deserve an effective, efficient and accountable guardianship system that provides them with the tools they need to make important decisions for their loved ones.

The absence of an effective guardianship system hurts vulnerable adults and their families, and wastes taxpayer money and time for state courts. The UGCOPAA would modernize current state law; provide for stronger, more effective forms of court oversight and enforcement; require exploration of less restrictive options before the appointment of a guardian; and, would promote autonomy, basic rights and dignity of the individual under guardianship.

Guardianship should be an option of last resort. But if it’s the necessary decision, let’s make sure seniors have options that best meet their needs, and without having to give up all of their rights. AARP urges the Alabama Legislature to enact the Uniform Guardianship, Conservatorship and Other Protective Arrangements Act now to bring our guardianship system into the 21st century.

Candi Williams is the AARP Alabama state director

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AARP Alabama state director: Alabama’s seniors need a modernized guardianship system

Maryland lawyer wins limited Fifth Amendment victory in ethics case

By: Madeleine O'Neill

A Maryland lawyer who invoked the Fifth Amendment during a bar counsel investigation into ethical violations will get the chance to present mitigating factors to a judge following a new ruling from Maryland’s highest court.

The lawyer, Edward A. Malone, will still face disciplinary action for violations of the Maryland Lawyers’ Rules of Professional Conduct under the decision, issued Monday.

But Malone will first be allowed to address a hearing judge and present mitigating factors to be weighed before he is sanctioned.

The question of Malone’s testimony arose because he refused to answer questions from bar counsel during a deposition in March 2021.

Malone first tried to block the deposition and objected “on the grounds that it serves no other purpose than to annoy, embarrass and oppress me,” according to an email quoted in the Court of Appeals opinion. “Put simply. I am not sitting for a deposition. And if that means the Maryland Court of Appeals will revoke my law license, then so be it.”

When he sat for the remote deposition, Malone invoked his Fifth Amendment right against self-incrimination and refused to answer any questions, including stating his name.

A hearing judge later ruled that Malone could not testify at an evidentiary hearing over his conduct and that he had invoked the Fifth Amendment in bad faith at his deposition.

The case against Malone stems from allegations that he intentionally failed to disclose his disciplinary history in Maryland and in Virginia when he applied to join the Texas bar.

In 2012, Malone received a private reprimand from then-Chief Judge Deborah K. Chasanow in U.S. District Court in Maryland. Chasanow issued the private reprimand because Malone had been held in contempt for missing a hearing in bankruptcy court without proper justification.

In 2011, the Virginia State Bar issued a public reprimand against Malone for failing to represent clients and for failing to respond to a bar counsel investigation. Malone’s Virginia law license was then suspended because he did not pay disciplinary costs associated with his sanction. His law license was forfeited in 2013 after he failed to pay dues for two years, according to the Court of Appeals opinion.

Malone failed to disclose any of that disciplinary history, or the fact that he was admitted to practice law in Virginia, when he applied to join the Texas bar, a hearing judge found, in violation of Maryland’s rules of professional conduct for lawyers.

Malone claimed at his evidentiary hearing that he did intentionally leave Virginia off his application to the Texas bar in order to hide his past discipline there, but that he did not intentionally fail to disclose the private reprimand in Maryland. He said he had forgotten about the private reprimand, according to the decision.

The Court of Appeals agreed with the hearing judge’s finding that Malone committed the violations, but found that Malone should have been allowed to testify about mitigating factors as the judge weighed what sanction to recommend.

“Because Mr. Malone should have been permitted to testify fully at the evidentiary hearing concerning mitigation — notwithstanding his earlier invocation of the Fifth Amendment in response to bar counsel’s deposition question about mitigation — we order a limited remand to the circuit court to allow Mr. Malone to provide such testimony,” Judge Jonathan Biran wrote for the Court of Appeals.

The court also found that bar counsel should have filed a motion to compel Malone’s testimony after he invoked the Fifth Amendment at his deposition. Instead, bar counsel filed a motion in limine to block Malone from testifying at his evidentiary hearing.

Bar Counsel Lydia E. Lawless declined to comment for this story.

Malone provided a comment through his lawyer, Craig Brodsky.

“Mr. Malone is pleased that the Court of Appeals recognizes the importance of the Fifth Amendment and determined that he should have been permitted to put on mitigation evidence at trial. We cannot say much more until the case has concluded,” Brodsky said in an email.

Malone’s Texas law license was withdrawn and canceled in 2016, after the Texas Board of Law Examiners learned of the discipline he had left off his application. The following year, after Malone reapplied to the Texas bar, the board found that Malone did not have the good moral character required to be a lawyer in Texas.

Malone was also indicted in 2016, after his Texas law license had been canceled, for “holding himself out as a lawyer” at an event where lawyers typically read the Declaration of Independence. The indictment was later quashed.

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Maryland lawyer wins limited Fifth Amendment victory in ethics case

Diner says thieves targeted her at Metro Atlanta restaurant

COBB COUNTY, Ga. — A diner at a Cobb County Cracker Barrel restaurant said she became a crime victim there.

Channel 2′s Cobb County Bureau Chief Chris Jose spoke with a victim who is warning families and walking us through how she was tricked.

The victim said the crime happened at the Cracker Barrel location on Chastain Road near Kennesaw State University.

“I want to be bold, but also want to be smart,” said the victim who asked to be identified under the alias of Jeannette Smith. She is worried because the perpetrators have her personal information.

“I probably look vulnerable,” she said. “I’m a senior citizen. I probably look like an easy target.”

Smith said one of the perpetrators held open the restaurant’s exterior door for her but then blocked her from entering the foyer. The pause permitted the other person to unzip Smith’s purse and steal her wallet.

“He acted like he was opening the door and holding it for me but he was actually blocking it so I couldn’t get through,” Smith explained.

Smith said how quickly the crooks acted is what truly caught her off guard.

“And they’re doing it in the foyer. Probably not just Cracker Barrel, other places with a foyer, with double doors. So you go in one door and then you have to go through the other door and there’s no security camera. It’s a very, very clever scam,” she said.

Within 30 minutes, the thieves were using the credit cards at retail stores, Smith said. One purchase included $3,000 worth of gift cards at Sam’s Club. Smith spoke with a manager who said he received multiple reports of a similar scheme. Police are investigating.

“If this were your mother, if this were your sister, and somebody did that to them, how would you feel?” Smith asked.

A spokesperson for Cracker Barrel emailed a statement that said in part:

“After speaking with the guest on that particular day, we engaged local authorities for an investigation into the reported incident and stand ready to work with them.”

Smith is hoping retailers will install additional cameras to help stop these kinds of crimes.

“I’m begging all these restaurants, these department stores and places like that, that have these foyer areas, please put security cameras in there so this could stop,” she said.

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Diner says thieves targeted her at Metro Atlanta restaurant 

Over 30 States Legally Allow Forced Sterilization | Opinion

by Ma’ayan Anafi

Singer Britney Spears arrives for the premiere of Sony Pictures' "Once Upon a Time. .. in Hollywood" at the TCL Chinese Theatre in Hollywood, Calif. on July 22, 2019. VALERIE MACON/AFP via Getty Images

Last summer, Britney Spears stunned the public when she revealed that her father, acting as her conservator, prevented her from removing her IUD. What shocked many people wasn't only the blatant disregard for her right to make decisions about her body: it was that it was perfectly legal for her conservator to take that decision away. Propped up by laws all over the country, guardianship systems (sometimes called conservatorships) deprive primarily disabled people from making some of the most basic decisions about their lives.

The horrifying truth is that Britney's experience under guardianship and its legality is just the tip of the iceberg. Quietly embedded in legal codes across the country, many state laws grant courts a draconian power: the power to order disabled people to be permanently sterilized against their will.

I recently authored a new report that exposed just how far-reaching these threats to disabled people's reproductive rights are. The report, released by the National Women's Law Center with contributions from the Autistic Women and Nonbinary Network, detailed how the majority of states—31 states in addition to Washington, D.C.—explicitly allow court-ordered sterilization of disabled people.

These laws are not fossils of a bygone era. States have passed new forced sterilization laws well into the 21st century, including two laws passed as recently as 2019.

Under these laws, a court can order the forced sterilization of people who—according to the judge—cannot make an informed decision for themselves. When disabled people like me are empowered and supported, we can make our own decisions about sterilization. But those who end up before a judge are rarely given that support; many are not even given the chance to try at all. Disabled people—particularly those with intellectual and developmental disabilities, and often but not always those under guardianship—may find themselves declared "incapacitated" with little fanfare and as a matter of course.

What makes these laws even more insidious is that courts purportedly order the sterilization for the disabled person's own good. The judge, often with broad discretion, can force someone to be sterilized on the grounds that it is in their best interest. Based on little more than speculation and stereotypes, judges have claimed that having a baby would be a tragic burden for a disabled person, a burden the courts are benevolently alleviating by having them sterilized.

The paternalism undergirding these laws—the belief that disabled people can't or shouldn't make their own decisions about their bodies—is painfully familiar to many disabled people. It echoes the paternalism on display in the early 1900s, when states forcibly sterilized nearly 70,000 disabled women, women of color and other "undesirables"—often with the same claim that it is for their own good. It's the paternalism we see in routine interactions with health care providers, in court rulings that deprive parents of custody based solely on their disability and in laws that grant guardians barely-fettered powers to make decisions about our reproductive futures.

On the surface, forced sterilization laws seem designed to protect disabled people. These laws require a special process and a judge's green light before the extraordinary step of forced sterilization. But procedural safeguards do not transform a forced sterilization into a voluntary one. They do not change the fact that these laws take the decision out of disabled people's hands and put the state's seal of approval over the violation of our bodies. Special procedures for forced sterilization do little to give disabled people more control over our futures. For that, we need large-scale reform, starting with dismantling the guardianship system as it currently stands.

Britney Spears' case was unusual—not because of her conservatorship or her forced IUD, but because she had the platform to share her story, generate public outcry and ultimately win control over her body. There are many more people whose stories have gone unnoticed. These stories demand change. They demand a world where no one—not a guardian, nor a judge, nor a doctor—can force someone to be sterilized.

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Over 30 States Legally Allow Forced Sterilization | Opinion 

Geriatric Emergency Rooms: Better Care, Better Value and Becoming More Common

Geriatric ERs are game-changers in health care. Here's why older adults need them and how they have evolved.

 

By Nora Macaluso

A hospital's emergency department is not always the best place for older people. The problems that bring these patients in may be complicated or made worse by long waits, lack of food and even some standard procedures, doctors say.

Credit: Getty

While younger people generally go to the emergency department after one-time crises, older adults more often show up because of exacerbating events related to underlying conditions, such as a frailty-related fall or shortness of breath due to congestive heart failure, said Dr. Ula Hwang, professor of emergency medicine at Yale School of Medicine and a key researcher in geriatric emergency medicine.

"It's not like we're going to fix [the condition] and they're never going to have it again," Hwang said.

Medical centers around the country are taking note, setting up separate emergency departments or instituting separate policies for emergency geriatric patients. It's improving care and saving money, and the value will become even more evident as the population ages, hospital administrators say.

Anne Arundel Medical Center in Annapolis, Md. opened an acute care unit for older patients in 2013, said Lillian Banchero, senior director for the medical center's Institute for Healthy Aging.

"In these few short years, we have gone from an average age of patients of sixty-five to an average age of eighty-five," Banchero said. "Up to a hundred and two is not uncommon here."

A Collaborative for Change

Anne Arundel is part of the Geriatric Emergency Department Collaborative, an initiative designed to better serve older Americans in the emergency department led by the American College of Emergency Physicians (ACEP), American Geriatrics Society, Emergency Nurses Association and Society for Academic Emergency Medicine. It's supported by the John A. Hartford Foundation (a funder of Next Avenue), and the Gary and Mary West Health Institute.

Yale's Hwang is also involved with the collaborative.

"Emergency room practices have changed," Banchero said. In the past, "it didn't matter what you had, when you came in the door, you got IVs and a full catheter, maybe some anti-anxiety medication," she said. "We're just not doing that anymore."

Instead, patients are evaluated individually and there's an effort to involve families and caregivers, she said.

The hospital last year hired its first geriatrician, which is "a dream come true," Banchero said. Having that person on staff "will make all the difference," she noted.

Geriatricians are "few and far between," Banchero said, adding that it's important to have someone who understands the unique needs of older adults, just as it's important to have pediatricians to address the way children present symptoms and deal with the stress of being in the hospital.

"Over the years, we've developed policies, procedures and best practices about how to care for the elderly," Banchero said. "Delirium is one thing we've worked hard on. Up until two years ago, we weren't focused on screening for delirium. Yet it's present in almost sixty percent of our patients."

Education Is Key

Before the hospital started focusing on geriatric medicine, delirious patients were dismissed as "sundowners" (a dementia sufferer who is negatively affected after sunset) and not treated. Now, they get early intervention to prevent the syndrome, Banchero said.

Diversion activities keep patients occupied, preventing them from panicking or from falling as they try to get up, she added.

"The biggest thing we did was education," Banchero said. That includes sending leaders to education courses and getting them certification through programs such as Nurses Improving Care for Healthsystems Elders, she said.

In the ER, the hospital puts together "delirium carts" for patients, with amenities like crossword puzzles, reading glasses, hearing amplifiers and phone chargers — "things that enhance their stay" — Banchero said. "Somebody comes in, they get Grandma into an ambulance, and she's forgotten her glasses, her walker, or her charger. When they get [to the hospital], that's what they want."

Providers are also trained to talk to patients with more of an understanding of their lives, Banchero said.

Many patients "have already articulated what their plan for the rest of their life is," she said. "We need to be present and talk to the patient about what they want," whether it's palliative care or more aggressive treatment.

For some people, the goal might be to make it to a grandchild's wedding a week away, "so then you change the plan of care," Banchero said.

Accredited Geriatric ERs

Anne Arundel's Institute for Health Aging has Level 3, or bronze, certification from the American College of Emergency Physicians, meaning it has at least one doctor and one nurse trained in geriatric emergency medicine, provides access to mobility aids and round-the-clock food and drink, and has taken a "geriatric emergency care initiative" such as a catheterization policy.

Level 1, or gold, certification goes to hospitals with several specific policies and procedures in place, including at least 20 age-specific protocols and staffers dedicated to geriatric patients.

There are more than 280 accredited geriatric emergency departments in 41 states and four countries, and the goal is to have 500 by the end of 2022, said Dr. Kevin Biese, chair of ACEP's geriatric accreditation board of governors. By contrast, there are about 5,000 emergency departments in the United States, he said.

ACEP started its accreditation program about three years ago in response to a system that "wasn't designed optimally for the needs of vulnerable older adults," Biese said.

The idea was to standardize the guidelines and approaches hospitals were taking to provide better care for that population. ACEP has three levels of accreditation, each with a greater set of "best practices" for hospitals to follow, Biese said.

"Whole health care systems are really leaning in" to the concept, he added. Participating systems include the Cleveland Clinic, Mayo Clinic, Northwell and academic centers including the University of California, San Francisco.

The Veterans Administration recently announced plans to establish 70 geriatric emergency departments by December 2022 through a partnership with ACEP, the John A. Hartford Foundation and the West Health Institute. Nearly half of U.S. veterans are over 65 and account for more than twice as many emergency department visits as older adults nationwide, the VA said.

States are also embracing the idea. Biese noted initiatives from New York and California: New York's 2017 Age-Friendly Health System Initiative calls for 50% of health systems to be age-friendly within five years and includes the establishment of age-friendly emergency rooms. California's Master Plan for Aging includes support for expanding geriatric emergency department certification.

What's more, Biese said, insurers — including Medicare — are taking note.

A study published in JAMA Network Open in March 2021 found that Medicare beneficiaries treated by transitional care nurses or social workers in the emergency department cost Medicare as much as $3,000 less than those treated at hospitals without geriatric emergency departments.

"It makes the health care system more sustainable," Biese said. "The traditional emergency department does a really good job of fixing you after you fall. The geriatric emergency department helps you not fall again."

Fall prevention, dementia screening, "medication reconciliation" (putting together a list of all the medications prescribed by a patient's various doctors) and delirium evaluation are among the major benefits a geriatric emergency department can provide, according to Biese.

While the department doesn't diagnose dementia, staffers can provide referrals and make sure family members or caregivers are aware of the process, he said. Staffers are also trained to spot signs of possible elder abuse or neglect and help families cope.

A geriatric emergency department can pull in specialists like social workers, case managers and physical therapists, setting patients up with services and releasing them safely, rather than admitting them to the hospital where their frailties may worsen, said Hwang.

"Emergency medicine's not really geared to that," she said.

Creating a 'Senior Emergency Center'

Hospitals don't have to "hire a whole new team" to set up an effective geriatric emergency unit, though, Hwang said. Leveraging the social workers and therapists who are already in the hospital and bringing them to the emergency department for assessments is an "ounce of prevention" that may allow a patient to go home earlier and avoid future hospitalization, she noted.

That's the philosophy at Holy Cross Hospital in Silver Spring, Md., said Scott Graham, director of emergency preparedness. Holy Cross' "Senior Emergency Center" is a separate area of the emergency department with softer lighting, less noise, slip-resistant floors and other features making the experience less stressful for older patients, Graham said. 

Doctors and nurses are trained in geriatric care and communication and "everything is self-contained," so patients can see what's going on and health care providers can see them, he said.

Care managers in the department assess patients' needs and "try to get a picture of the home" to make sure each person is sent home with appropriate support and potential hazards are addressed, Graham said.

Creating a successful geriatric emergency department "doesn't happen overnight," Hwang said. "It takes a lot of working with the other disciplines" and coordinating resources, she said. That's challenging at a time when hospitals are crowded and short-staffed, she added.

"I think people in their own communities should know where geriatric emergency departments are," and if one is not nearby, encourage the local hospital to become one, Biese said.

"I think it's something that communities should ask for, or demand, of their local hospitals," he said. "If you had a child at home, there's a good chance you'd know where the pediatric emergency department was," he added, saying the same should hold true for older adults.  

As the population ages, demand for better geriatric emergency care will continue to grow, experts believe.

"We all need to be striving to really focus on geriatric care," Banchero said. "This is not just something fleeting in the night. This is reality."

Full Article & Source:

Geriatric Emergency Rooms: Better Care, Better Value and Becoming More Common

Columbia man arrested on charges of deceptive business practices

By Emma J. Murphy

Blake Mahoney, the owner of MO State Construction, was arrested Thursday morning and charged with deceptive business practices and the financial exploitation of elderly and/or disabled people.

Mahoney, 28, and his construction company are accused of failing to follow through on contracted work despite receiving money upfront for the jobs.

The Better Business Bureau has received eight complaints over the past three years about Mahoney and MO State Construction’s failure to deliver on its promised services. Four of these complaints have been in the past 12 months.

According to Better Business Bureau files, a Columbia woman reported that she hired the contractor in 2020 to replace her roof and siding. She paid $8,000 to the business in two installments, but the woman said the project was abandoned after she submitted the second check.

A woman from Gravois Mills told the Better Business Bureau she hired the company in 2019 to build a garage and do excavation work on her property near the Lake of the Ozarks. She paid the company $25,000, but only some excavation work was done before the builder left and kept the down payment.

Complaints to the bureau reveal a pattern of taking payment from clients for materials that were never delivered, failing to communicate and not issuing refunds.

In February 2021, the bureau gave MO State Construction the lowest grade available: F. It has warned Columbia residents to avoid using Mahoney’s services because of the history of unfinished construction projects.

Mahoney’s next hearing is scheduled for Feb. 7. He is being held in the Boone County Jail, and his bail has been set at $100,000 cash.

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Columbia man arrested on charges of deceptive business practices

As­sem­blyman in­tro­duces leg­is­lation to curb con­ser­va­torship misuse

In this Sept. 14, 2017, file photo, Assemblyman Brian Maienschein, R-San Diego, speaks before the Assembly in Sacramento, Calif.

By City News Service Sacramento

LOS ANGELES (CNS) — With the Britney Spears case playing out in Los Angeles civil court, an assemblyman Wednesday introduced legislation aimed at reforming state conservatorship laws to limit abuses of the system and provide alternatives for conservatees.

Assemblyman Brian Maienschein, D-San Diego, says AB 1663 — The Probate Conservatorship Reform and Supported Decision-Making Act — will ensure probate conservatorships are used only a last resort, due to the potential for exploitation of those the appointments are intended to serve.

The legislation would support alternatives that provide greater agency to conservatees, require courts to consider other alternatives first, make conservatorships easier to end and require conservators to make decisions "aligned with the conservatee's wishes or previously expressed preferences."

In a statement, Maienschein said that prior to his legislative career, he clerked for a San Diego Superior Court judge and "saw firsthand the role that the court plays in establishing probate conservatorships and how the system could be abused and misused."

Though state law holds that conservatorships should only be used if they are the least restrictive alternative, Maienschein said they are often granted without consideration of other options and with few re-evaluations of the conservatees' ableness. 

"It's time that we take action to reform the probate conservatorship system in our state," Maienschein said. "It is reform that is long overdue."

In a statement announcing AB 1663, the assemblyman highlighted the highly publicized case of Spears' 13-year conservatorship, which the pop star was only recently able to have terminated.

A post-conservatorship hearing was scheduled for Wednesday in Los Angeles in the Spears case.

AB 1663 has garnered support from disability rights groups, as well as the #FreeBritney movement that emerged amid reports of Spears' efforts to end her conservatorship and allegations of wrongdoing at the hands of her conservators.

"We started our movement for Britney Spears, but we quickly learned that conservatorship abuse is rampant across the state of California and beyond," said Leanne Simmons, Free Britney L.A. organizer. "The successful termination of Britney's conservatorship helped to shine a light on the problems with conservatorships, but there is much work to be done."

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As­sem­blyman in­tro­duces leg­is­lation to curb con­ser­va­torship misuse