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Baker Act is cruel, unfair to elderly, their relatives say

One by one, the children and grandchildren of elderly Floridians stepped up to the lectern. With tears brimming, they told lawmakers how the state's involuntary commitment law had allowed mental hospitals to lock up their loved ones despite their objections.

At a daylong hearing, about two dozen speakers gave impassioned pleas for reforming the Baker Act. Eleven legislators attended, as did Elderly Affairs Secretary E. Bentley Lipscomb and a host of regulators, mental health professionals and court officials.

"God help all of us," said Paula Drutman, whose 88-year-old mother was taken from a Palm Harbor nursing home to the Manors psychiatric hospital in Tarpon Springs. "I hope no one goes through what I had to go through to get my mother out."

Drutman's mother suffers from senile dementia. In February, after the 88-year-old slapped a nurse, a "crisis team" from the Manors was called to evaluate her. Drutman said she warned the nursing home to take no action without consulting her, and she had insisted her mother not be taken to the Manors.

But at 10 o'clock that night, Drutman said, she received a call from the Manors: Her mother was there.

"My mom does have dementia," Drutman said. "But, no, she is not dangerous.

"This should never happen, but it did. It's cruel, very cruel, what they did to my mother and everyone else," she said, fighting back tears.

Tuesday's hearing of a subcommittee of the Florida House Committee on Aging and Human Services was called by state Rep. Mary Brennan, a Pinellas Park Democrat. She said the hearing was prompted by a recent Times series that highlighted abuses of the Baker Act and raised disturbing questions.

The series, called "A Dangerous Age," used court records from 1993 to 1994 to show Pinellas County led the state in psychiatric commitments. Experts said that many of the elderly people who were locked up could have been treated in their nursing and retirement homes, saving Medicare millions of dollars.

The hearing, Brennan said, will help change the Baker Act, which was passed more than 20 years ago. Well over 100 people attended the hearing, and 50 to 60 had asked to speak, though many left disappointed. They will get another chance Sept. 28, when the committee holds its next hearing in Clearwater.

Suggested changes included having nursing and retirement homes treat more people in place rather than sending them to psychiatric hospitals; closer court supervision of patients who volunteer for treatment, and fines for caregivers who violate the law.

Pinellas-Pasco Circuit Judge Thomas E. Penick Jr., who has overseen hundreds of Baker Act hearings, proposed that the Legislature redefine mental illness and stop the commitment of people whose bad behavior is driven by Alzheimer's disease, dementia and other "diseases of the aging process."

"You might think that these are isolated cases, individual cases with stories to tell," Penick said, referring to the testimony of family members. "What you hear today is just the tip of the iceberg from what we hear from judges around the state."

Phyllis Rice had a story to tell.

Her 95-year-old grandmother was taken involuntarily from a St. Petersburg retirement home to a mental hospital April 20 after she climbed a fire escape to the home's roof. The woman's daughter had died that day from a terminal illness.

At the Manors, Rice said, her grandmother fell and injured her hip, her shoulder and her wrist. She died a month later. Her death certificate said she died of dehydration, Rice said.

Before her grandmother was committed, "she was mobile, she raked the yard, she watched Jeopardy! and did the New York Times crossword puzzle," Rice said.

"In a short time, she lost everything: her only child . . . her life."

Ansel Briggs of Homosassa said his 82-year-old mother was so traumatized by her commitment to a mental hospital that she has moved from Florida and refuses to come back.

It started in July 1994 when Briggs took his mother to an adult day care center at a Citrus County hospital. When he returned about seven hours later to pick her up, Ruth Briggs was nowhere to be found, he testified.

At first, officials at Heritage Beverly Hills hospital refused to tell Briggs that his mother, an Alzheimer's patient, had been locked up under the Baker Act, he said. And when he found out, hospital workers told him there was "nothing I could do because it's a weekend."

"They tested my mother for heroin, for cocaine and for cannabis _ and they had Medicare pay for it," Briggs testified.

Fighting tears, Briggs told lawmakers how powerless he felt when he could not spring his mother from a mental hospital.

"We always take care of our family," he said. "We take care of our own. When they took this out of my hands, it really made me mad."

Under the Baker Act, people who might be mentally ill and dangerous to themselves or others are evaluated by a doctor or mental health professional. If that evaluation determines that they need hospitalization, they are supposed to go to the nearest state-approved psychiatric facility.

But in 1993 and 1994, scores of patients streamed into Pinellas County psychiatric hospitals from distant counties, the Times' series revealed. Often, evaluations occurred after they arrived.

Several speakers suggested that the Baker Act specifically outlaw movement of people to psychiatric hospitals without evaluations.

"We strongly recommend that evaluations be done prior to transfer," said Gloria Henderson, director of the Division of Health Quality Assurance at the Agency for Health Care Administration in Tallahassee.

Many people are forced into the hospital, only to quickly admit themselves as voluntary patients. That eliminates all court oversight of their hospital stay. According to advocates and court officials, many patients admitted themselves out of fear or pressure. Others had no idea what they were doing.

The Baker Act needs some mechanism to assure that voluntary patients are competent to direct their own care and understand their rights, said Robert Constantine, head of mental health for the Department of Health and Rehabilitative Services.

When voluntary patients ask to leave, the hospital can hold them a week or more. The law "should dramatically shorten the time that voluntary patients can be held against their will," Constantine said.

He also suggested that authorities question why some counties are loaded with psychiatric beds that can hold Baker Act patients while other counties of similar size have many fewer beds.

"Almost by definition, the more designated receiving facilities, the more likelihood of emergency evaluations and petitions," he said.

Lipscomb, who heads the state's elder affairs agency, did not speak Tuesday. But he released a five-page statement with detailed recommendations of his own.

Among them, Lipscomb called for the appointment of a Baker Act investigator _ or monitor _ to ensure that elderly patients be treated in less restrictive settings, such as nursing homes.

"One of my biggest fears," Lipscomb said, "is that with 339,232 people in our state with Alzheimer's today _ and growth expected to be nearly 400,000 by 1999 _ the potential for this type of alleged exploitation will continue to be great."