‘A horror movie’. Florida program that removes elders from their homes needs overhaul, oversight, lawmakers say

Florida lawmakers, expressing outrage at the “atrocious” and “unconscionable” treatment of elderly people, vowed to reform the state’s adult protection program in the wake of a Miami Herald investigation that showed how frail seniors were moved without their consent into substandard care homes.

“I want to know what happened. I want to know how we failed these people,” said State Sen. Ileana Garcia of Miami, whose district includes more elders per capita than any other in Florida. “This could be you and me tomorrow. This could be our parents tomorrow. Why would you be OK with that?”

In a series of stories called “The Gray Market,” the Herald reported that Florida data show nearly 95% of elders and disabled adults taken into state custody for their own welfare never appear before a judge or consult a lawyer. Some elderly people are deposited into homes with long records of violations without the knowledge or approval of family members or others with power of attorney.

Parents went missing

The Herald found instances where a daughter caring for her father and a daughter caring for her mother had no idea that their parent was transferred from a hospital to an assisted living facility they had never heard of. They had to embark on what they described as search-and-rescue missions to be reunited with their loved ones.

Decisions about where elders in state custody will live are made almost exclusively in Miami-Dade County by one Department of Children and Families caseworker, Tania Hernandez, who has been accused by colleagues of overruling their placement decisions and accepting kickbacks from assisted living facility owners hoping to fill empty beds with clients on Medicaid. In a county with more than 800 ALFs, Hernandez typically chooses from a collection of her preferred homes, colleagues said.

Internal investigations found no wrongdoing on the part of Hernandez or facility owners named in agency reports. Hernandez denies the accusations. She told an investigator many ALFs refuse to accept seniors from DCF’s caseload of at-risk people removed from their homes.

The Herald found that DCF’s Adult Protective Services program has placed elders in homes with scores of violations — at the same time that health leaders in a separate state agency were seeking to shut them down.

Neither DCF nor Hernandez replied to a request from the Herald to address state lawmakers’ concerns. The agency declined in recent months to discuss the stories or provide documents under the state’s public records law.

Garcia, a Miami Republican who is vice chair of the Children, Families and Elder Affairs Committee in the Florida Senate, is the caregiver for both her mother and a grandmother who is turning 100.

“Where is it written in statute that DCF has the power to bypass the judicial process and take people’s freedom away — taking them out of their homes and placing them wherever they deem is best without due process?” she said.

“It just blew my mind. I could not wrap my head around how that happened.”

Calling the Herald’s findings “atrocious” and “unacceptable,” Garcia said she is asking questions of agency leaders and talking with fellow legislators about how to change laws.

Miami-Dade State Attorney Katherine Fernandez Rundle said protecting elderly people from predators who take advantage of their mental or physical infirmities is a priority of her office. She created the Elder and Vulnerable Adult Exploitation Unit to address the rise in financial crimes against elderly victims, and has prosecuted cases in which elders who lack the capacity to consent have been manipulated into signing over their assets.

Rundle — as well as members of her specialized unit, which she calls “EVA,” reviewed the Herald’s reporting with an eye toward supporting reform, she said in an interview this week. The series, she said, suggested the possibility of “patient brokering” within the elder protection system — something she considered “deeply disturbing.”

“We are going to look into it,” Rundle said, adding that the effort “obviously starts with DCF.”

“I, and our team, are going to do what we can to review and look into these allegations and ascertain what is occurring, how to end it and how to bring reform to the system.”

READ MORE: ‘Tania always decides’: Miami’s most fragile seniors are in one woman’s hands

Rep. Alex Andrade, a Pensacola Republican who chairs the Health Care Budget Subcommittee and serves on the Health and Human Services Committee, said he was so alarmed by what he read that he asked House leaders whether lawmakers could begin reforming adult protection at an upcoming, though unscheduled, special session to pass a state budget.

“This paints a really grim picture,” Andrade said. “It’s horrifying to think this is happening in Florida.”

If lawmakers are not setting aside enough dollars for DCF to ensure elders have due process when they’re taken into state custody, the agency has never said so, Andrade said.

“If a state agency is not telling us that, it’s kind of tough for us to pinpoint the actual problem,” he said. “That’s the give and take. Do you trust the people running DCF to do this properly and avoid circumstances like this in the future?

“At this point, I don’t have a lot of faith in leadership at DCF acting in good faith and caring enough to drill down into the problem and fix it. The focus should be on getting it right.

“The culture at state agencies has been to delay, deny and deflect as much as possible.”

Garcia and Andrade are likely to find support on both sides of the aisle in Tallahassee.

Rep. Allison Tant, a Tallahassee Democrat who serves on the House’s Health and Human Services Committee, called the series’ findings “disturbing.” She also pledged to demand answers from agency directors and seek ways to better protect elders through legislation.

Tant said lawmakers should consider “regulatory guardrails” that prevent elders from being held against their will in homes they don’t choose.

“I’ll be making several calls, and I can’t imagine my colleagues won’t be similarly interested,” Tant said. “Nobody wants this for their family member. Nobody.”

Tant said lawmakers have a duty to protect Florida’s seniors.

“This is not something seniors should worry about — being taken from their own homes and put in institutions with no steps in place for their loved ones to know what happened,” she said.

“It’s really unconscionable. It’s something you see in a horror movie.”

Like Garcia, Tant cared for her mother in her home for the last 10 years of her mom’s life. She said she can’t imagine her panic if her mother had been removed from a hospital bed “without the knowledge of family members.”

That is what a Kendall woman told the Herald happened to her when her father disappeared from his hospital bed. She tracked him down at a Miami ALF, unkempt, unshaven, with his clothes in a bag, she said.

In another case, the niece of a 79-year-old man who had power of attorney over his affairs said she called police and emergency rooms searching for her uncle after he was taken into state custody and moved to a Hialeah assisted living facility far from his North Miami Beach condo without her knowledge.

“What I can’t fathom is what these seniors are going through,” Tant said. “I can’t imagine their horror – their lives being upended this way.”

The vice chair of the House’s Human Services Committee, where Tant also serves, said he, too, expects straight answers from DCF leaders when he addresses the series with them. Rep. Fabian Basabe, a Miami Beach Republican, said his job is “to ensure that our systems are working as intended, and, when concerns are raised, to examine them carefully and act where needed.”

“I am already engaging with the Department of Children and Families and relevant agency leadership to review current procedures, including placement decisions, due process protections and family notification standards,” Basabe said.

“Over the coming months this will be a priority. I will be working with agency staff, subject matter experts and stakeholders to develop legislative solutions that strengthen oversight, improve transparency and ensure that vulnerable adults are protected without compromising their rights or dignity.”

Rep. Fentrice Driskell, a Tampa Democrat who is minority leader in the House, said she would like to make protecting elders from abuse a priority during the next legislative session, when she hopes to serve in the Senate.

Driskell said she was surprised to learn that DCF caseworkers have the authority to remove elders from their homes, physically relocate them to a facility — and determine, with no judicial oversight, whether they are competent to agree to the move.

Better coordination among state agencies would result in fewer elders being sent to poorly performing homes, Driskell said. The Herald stories showed DCF adult protection caseworkers are sending elders in their custody to homes that the Agency for Health Care Administration inspectors have cited for numerous violations, including serious lapses in care.

A pilot project requiring judicial oversight could be developed for Miami-Dade County where the Herald identified abuses, Driskell said.

Legislators have the authority to pass laws protecting elders from government abuses, but also the power of their “voice” to hold leaders to account through agency oversight, Driskell said. Potential reforms could include automatic court hearings “that take some of the discretion out of agency hands.”

“We tout Florida as a beautiful place to retire, where you can spend your final years in safety with quality healthcare and a decent life,” she said. “I couldn’t believe this was happening.

“Nobody thinks about what it will be like when they are themselves seniors.”

Herald/Times Tallahassee Bureau reporter Alexandra Glorioso contributed to this report.