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Who watches the watchdog for the elderly?

Janice Mantia charged into elderly Bibianna Bach's life like a savior.

Mantia, then a state-paid watchdog for elderly abuse, went to court in 1992 to win control ofBach's finances, saying the childless Tamarac widow was too ill to pay her own bills.

But 17 months after Mantia entered Bach's life -- and began paying herself $35 an hour with theold woman's money -- the 78-year-old widow died broke, malnourished and bedeviled by bed sores.

"She was 5-foot-2 and 66 pounds," said Dr. Raul Vila of the Broward Medical Examiner'sOffice, who performed the autopsy in August. "She looked like she came from a death camp."

The state Department of Health and Rehabilitative Services, after investigating Mantia,alleged that she neglected Bach and exploited three wards of the private guardianship business shebegan while moonlighting from her full-time state job. Mantia is challenging the findings through astate appeals process.

"I don't feel I've done anything wrong," said Mantia, 51. "I happen to care a lot about thesepeople. They are important to me. They are important to my life, and not for the income."

Court records show that Mantia gave questionable care to some wards and charged people -- whohad lost their legal right to contest her bills -- thousands of dollars for services they could havebought at less cost elsewhere.

Records also show that the court system supposed to protect vulnerable wards and to policeSouth Florida's burgeoning private guardianship industry has failed in some of Mantia's cases:

* One of Mantia's wards required surgery because she left one or more tampons inserted weeksafter HRS workers warned Mantia that the woman had a strange odor and discharge and needed agynecological exam.

* Another ward, an aging Fort Lauderdale woman, has been trapped in a Margate retirementhome, stripped of her legal rights and cut off from her money for more than two years -- even thoughshe is now sober and sane and should have most of her rights restored, according to her doctor andexperts who have evaluated her for the court.

* Mantia's company billed a Sunrise family three times for the same court hearing and chargeda retarded man $210 to take him fishing. She charged a Margate woman $122.50 to visit and clean herrefrigerator, and charged two elderly wards a total of $900 for staying with them 15 hours duringHurricane Andrew, court records show.

While Mantia denies neglecting or financially exploiting her wards, she acknowledges "sloppybookkeeping" and concedes she does not have documentation to prove she has worked all the hours forwhich she has billed her wards.

Broward Circuit Court Judge W. Clayton Johnson, who signed some court orders authorizingMantia to charge wards questionable fees, said last week that he would not have if he had read herbills more carefully.

"I have to try to glance at them," said Johnson, who heads the court's probate division,where two full-time judges, a part-time judge and two general masters are responsible for monitoringbills in about 5,000 open guardianship cases. "We do not have enough help to watch this stuff. Wehave to presume people are honest."

But last year, when one family complained that Mantia was withdrawing too much from theirrelatives' accounts, Johnson said the complaints were unwarranted -- and slapped the complainerswith a court order barring them from criticizing Mantia.

Mantia was fired from her state job in December, after her employers said it was a conflictof interest to serve as both a guardian and a government watchdog. At one point, someone calledMantia's state-financed office to complain about Adult Guardianship Inc. -- only to find thatMantia, the woman answering the phone, ran the company, state officials said.

Mantia, who serves as a guardian in Dade, Broward and Palm Beach counties, denies there wasany conflict. She appealed her firing, and the state has since agreed to let her resignretroactively.

"I can look back now and say, gee, I made mistakes," Mantia said.

"The funnything is, there are many other guardians who charge the same things I do for the same things Icharge for." For old or otherwise frail people who can no longer manage their lives on their own,the state has established a solution. A friend, relative, lawyer, accountant or even a perfectstranger can petition a court to become their guardian and have them declared incompetent to handleall or some of their personal affairs.

Guardians have the right, with court approval, to pay themselves and their lawyers from theirwards' assets. State law does not specify how much guardians can charge. That leaves judges in eachcounty to establish and enforce billing guidelines.

Private guardianships are a fast-growing industry in South Florida, because the region has alarge elderly population and the government social service agencies that are supposed to help themare overwhelmed. A growing number of people take on multiple guardianships as a full-time job.

They provide a desperately needed service, helping their wards pay bills, arrange governmentbenefits and receive needed medical care, supporters say.

"What do you do when the family is up north and they say, 'To hell with Daddy. Wait 'til hecroaks, and then I'll come down and get the money then,' " Judge Johnson said. "A lot of thesepeople have been abandoned by their families."

Under state law, guardians are not required to have a state license, or even a high schooldegree. They just have to attend eight hours of training within one year of starting their firstguardianship.

"Almost anyone can be a guardian and have enormous power over someone else's life," saidEmilio Maicas, HRS program administrator of Aging and Adult Services in Broward. "There is nolicensing requirement, little monitoring or oversight. The potential for abuse is tremendous."

Mantia came to the job of guardian with one impressive credential. She was the only paidstaff member of the Long-Term Care Ombudsman Council in Broward, a patient-rights group thatinvestigates complaints of mistreatment in facilities like nursing homes.

Mantia's company, Adult Guardianship Inc., was founded in July 1992, according to staterecords. Mantia asked an elderly neighbor, Dorothy Collins of Coconut Creek, to work for her,Collins said.

Less than a year later, Collins quit the company because she was concerned that Mantia wasbilling wards for more hours of service than they had received -- an allegation Mantia denied.

"I like the concept of guardianships," Collins, 71, said last week. "It's beautiful. It'swhen you put in for time you don't deserve to get paid for, that's bad. I didn't want any part ofit, so I left."

Jennie Lee Waln was a grande dame in decline in the fall of 1991 when she becameMantia's first ward.

Her husband had committed suicide. She had fallen and broken both hips. She drank vodka todeaden the paralyzing pain, she said. And she entertained herself with late-night shopping sprees onthe television home shopping networks.

"I did wrong," said Waln, 69, who once lived off the Intracoastal Waterway in Fort Lauderdaleand still co-owns the building housing the posh Left Bank Restaurant. "I'm a human being. We do makemistakes. I was by myself, and I got scared."

Waln's accountant and Mantia -- whom Waln said she did not know -- went to court to have herdeclared incapacitated and stripped of her legal rights. A judge appointed Waln's accountantguardian of her property and named Mantia guardian of everything else, giving her power to decidehow and where Waln lived. Waln's furniture and car were sold, and Mantia moved her into MargateManor retirement home.

In the more than two years since she became a ward, Waln has been completely cut off from hermoney, not allowed to cash even a $5 check, she said.

Mantia has billed her bank account more than $10,000 -- including hundreds for visiting Walnand delivering cans of Fancy Feast cat food for her pet, Pierre. On Feb. 22 and 23 alone, Mantiacharged Waln $140 to deliver cat food.

Mantia defends the bills, saying, "There were times we had to go to four grocery stores toget the one kind of cat food that Pierre would eat."

In 1992, Waln asked lawyer Russell E. Carlisle to help her fight to have her rights restoredand her guardians dismissed, she said.

A court-appointed doctor examined Waln in June of 1992 and determined that she was notmentally ill and all her rights should be restored except the right to drive, court records show.Other experts testified at a hearing that her rights should be restored gradually, according tonotes in her court files. A general master recommended that some of Waln's rights be restoredimmediately.

Waln's regular physician, Dr. Ed Mease of Margate, a family practitioner, last week mailed aform to Mantia indicating that Waln is well and does not need the services of a guardian.

Mantia has fought termination of the guardianship, records show. She said Waln needs aguardian because she might abuse alcohol again if left on her own.

"I'd hate to see her end up in a body bag," Mantia said. "That would just be a shame."

Waln insists she is ready to take control of her life again.

"My heavenly days,it does sound preposterous," Waln said. "I wouldn't believe it if it hadn't happened to me."

"I'm more or less incarcerated, I guess you'd call it."

Pearl Fechterand her children live together in Sunrise. They have big, complicated problems, a large trust fundand, since early last year, Mantia as their guardian.

Fechter, who has Alzheimer's disease, and her two adult children, who are mentally retarded,were billed more than $35,000 in 1993 by Mantia and her attorney, court records show.

Sometimes the family paid Mantia three times for the same service, according to courtrecords. For one approximately four- hour-long court hearing in May, Mantia's company billed 12hours at $30 an hour and triple mileage, court records show. Mantia now says she spent the entireday of the hearing with the family, though she acknowledges that's not what her bill reflects.

In June, Fechter's daughter, Stephanie Perlmutter, 52, required surgery because she left oneor more tampons inserted weeks after HRS workers warned Mantia that Perlmutter had a strange odorand discharge and needed a gynecological exam, according to state and police records.

Mantia blames Perlmutter's incapacitated mother for the delay, saying she didn't want herdaughter examined. But when Mantia's company sought guardianship of the family, she said it waspartly because they had poor hygiene that needed correcting. And Mantia had the sole legal authorityand duty to make decisions about Perlmutter's medical care, court records show.

Bonnie and Stanley Bloom, relatives of the family, have questioned both the mounting cost ofthe guardianship and the quality of care the family is receiving, court records show. Theycomplained to Judge Johnson and various state agencies, including Mantia's employer, the Departmentof Elder Affairs. "To dissipate a person's life savings with superfluous 'care' and questionablefinancial obligations is, at the very least, inhumane," Bonnie Bloom wrote in a May 1993 letter toJudge Johnson. "Does it not negate the spirit of the Florida guardianship laws?"

Mantia said the criticisms were unfounded. Johnson agreed -- and issued an order enjoiningthe Blooms from criticizing Mantia or otherwise interfering with her ability to earn a living.

Johnson now says he issued the order to keep costs down because Mantia and her attorney werebeing forced to spend time -- and the wards' money -- defending themselves.

The Blooms are now afraid to discuss Mantia. "The judge said we couldn't, and we don't wantto go to jail," Bonnie Bloom said.

Bibianna Bach was bedridden with arthritis when Mantia became her guardian and required"total skilled nursing care to survive," according to court records.

HRS decided that Mantia neglected Bach because she failed to place the widow in a nursinghome with constant care, even after Medicaid agreed to pay for it, state records show.

HRS has classified Bach's death as "proposed confirmed" neglect, Maicas said. But Mantia isappealing the finding.

Mantia said she tried to place Bach in a nursing home but couldn't find one willing to takeher. Instead, a few weeks before Bach died, Mantia moved her to an unlicensed private home. Theowner provided only room and board, and nurses visited part-time, state records show.

A doctor visited Bach before she died, and if Bach was in danger, he should have noted that,Mantia said.

The physician, Dr. Justin May, said Bach was not in danger when he saw her, and he blamesBach's death on the person who reported Mantia to HRS. A call to the state abuse registry promptedHRS investigators, police officers and a fire truck to respond to the home where Bach was staying,May said.

"I honestly think they killed her by frightening her to death with all these men in uniformsaround," May said.

Mantia said she had moved Bach out of her Tamarac home so she could sell it to raise cash forher care. Mantia said she spent her own money for Bach's care in her final weeks and still hasn'tcollected hourly bills she is owed.

Mantia billed Bach more than $770 -- over 22 hours at $35 an hour -- for arranging thewidow's stamp collection and having it appraised, court records show. The collection was worth "$500at best," records show.

Mantia now regrets billing Bach so much for the collection. "I was a new guardian," she said."That's the way I thought I had to do it."

In her will, Bibianna Bach said her final wish was to be buried in a Catholic cemetery.

But when Bach died, Mantia had her cremated at a Jewish funeral home, records show.

"There was no money left," said Mantia, who adds that she cared so much about Bach that she kepther ashes. "I did the most economical thing I could do."

Waln, the woman in the Margate retirement home, is determined to break free of her guardiansso she may live and die on her own terms, she said.

"This could get very depressing if I let it," Waln said. "I can't just stop and say I'm goingto give up and let the whole thing go.

"I don't care about my money, and my furniture and my clothes. Those are gone.

"It's my life I want."

Herald staff writer Mary Hargrove contributed to this report.

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