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Judge angered after learning mentally ill Miami man was placed in assisted living facility, and escaped

After Cristobal Abreu was arrested when he allegedly stabbed a Hialeah SWAT officer with a large barbecue fork in December 2009, doctors deemed his mind too ravaged by mental illness to stand trial.

For years, he bounced around mental-health facilities.

Then a stay at a Miami Gardens assisted-living facility, where funds for his medications ran out and his mental state deteriorated, ended last month when the 72-year-old Abreu was shipped without a judge’s permission to Jackson North Medical Center.

Then last week, a Jackson caseworker — again, without permission from the court — sent him to an ALF in Little Havana.

Abreu promptly escaped.

“I’m free! I’m free,” he yelled as he shuffled away from the San Martin de Porras facility on Tuesday, according to lawyers and court personnel who described the episode over two days in court this week.

Abreu’s ping-ponging treatment drew the ire of Miami-Dade Circuit Judge Ellen Sue Venzer, who has now ordered hospital and state-contracted mental-health administrators to court Friday to explain what happened.

“The system is broken,” Venzer said angrily in court this week, adding: “What would have happened if Mr. Abreu had decompensated and gone out and hurt somebody else in our community?”

Abreu’s escape was short-lived: Police quickly detained him, committing him back to Jackson Memorial Hospital for an involuntary psychiatric evaluation.

The unusual episode underscores what mental-health advocates in Miami-Dade’s criminal-justice system say has been a recurring problem: “incompetent” defendants are often shuffled between facilities without the knowledge of the court tasked with supervising them.

ALFs mostly house the elderly and other people with mental-health issues or disabilities. It is not unusual for incompetent defendants, usually nonviolent ones, to be placed at an ALF in a residential neighborhood.

“The people in the social services arena have to recognize that a court order is sacrosanct,” Miami-Dade State Attorney Katherine Fernández Rundle said Wednesday. “I really understand the judge’s ire. She has the absolute right to be livid with everyone in the system.”

Subpoenaed to appear before the judge on Friday: representatives from Jackson, the South Florida Behavioral Network, which contracts with the state to manage cases of the mentally ill defendants, and the New Horizons Community Mental Health Center, which monitored Abreu’s case.

A lawyer for the Florida Department of Children & Families will also appear.

“It sounds like all these different agencies are treating these individuals like hot potatoes,” Venzer said in court Wednesday.

Abreu was initially arrested in December 2009 on charges of attempted murder and aggravated battery of a law enforcement officer. The attempted murder charge was later dropped; the SWAT officer was not hurt because the knife pierced his shield.

During a jailhouse interview with a psychologist, the incoherent Abreu admitted that he sometimes hears voices and sees visions of “flowers [and] gold diamonds.”

The court determined that Abreu was incompetent to proceed to trial, meaning he could not assist his lawyer in defending the accusations.

After stays in several other facilities, Abreu wound up in November at the Graceful Gardens ALF, 18101 NW 47th Ct.

But while there, lawyers said in court, the ALF stopped giving him medication because funds ran out, although they gave him insulin borrowed from another patient. Then the ALF checked him into Jackson North.

Then in early January, a Jackson case worker told the judge Tuesday, funding woes forced the hospital to move Abreu to the San Martin ALF.

Venzer chastised the case worker for ignoring a court order that mandated all placements be approved by the case judge.

“I want to make myself abundantly clear,” Venzer said. “I am so disturbed by this. Why do we go through these procedures if they are going to be ignored based on funding?”

Tuesday morning, Venzer also ordered a psychological evaluation of Abreu. That afternoon, the court-appointed psychologist called the ALF to make an appointment — only to learn Abreu had walked off.

Miami police later caught up with Abreu. No one notified prosecutors, Abreu’s defense lawyer or the courts until Wednesday morning.

Ed O’Dell, a spokesman for Jackson Memorial, declined to speak specifically about Abreu’s case because of privacy laws. But he said that the hospital system would review the case worker’s conduct.

“If any policies are found to have been violated, appropriate disciplinary and corrective action will be taken,” O’Dell said.

He also said that the hospital has no funding woes that would affect moving patients.

The South Florida Behavioral Network and the ALF owner did not respond to calls for comment.

The San Martin ALF, which has bed space for 12 patients, is in a residential neighborhood near the Miami River. Last year, state records show, the state cited the home for violations including not providing “exclusive” bed space for patients, a staff member sleeping for several days at the home and incomplete record-keeping.

Lawmakers have scrutinized ALFs in recent months after a Miami Herald series showed the state had allowed dozens of facilities to stay open, even after they had been caught abusing and neglecting residents to death.

New Horizons has been in the news before.

In 2009, the agency was supposed to monitor a Miami man, Sedrek Singleton, who was found incompetent on several criminal charges, which were later dropped. He was placed in a Liberty City ALF, where he allegedly bludgeoned his roommate and then killed another homeless man.

He was found incompetent after those attacks and now is in a secure state hospital.