Whose Best Interests?
Wearing slippers, sweats and a satin nightcap on this December afternoon, 76-year-old Margie Hill dangles her legs off the side of her twin bed and mimics the other residents: She glazes her eyes, pokes out her tongue and lowers her face to her chest.
"I hate this place," Hill says. "I can't stand to be around all these old people."
Hill occupies Room 102 at Lexington Place Nursing & Rehabilitation Center, a 200-bed private facility set along Houston's North Loop. She has three bunkmates and zero privacy in a room with naked walls, shabby furniture and buzzing fluorescent lights.
Three months ago Hill lived at home with her son in a cozy, well-furnished apartment. But after checking herself into a hospital, she was mistakenly deemed abandoned, shipped off to two different nursing homes and forcibly made a ward of the county.
Her normal life officially ended last month when Harris County became her guardian and exiled her to Lexington Place, a veritable firetrap that has been slapped with no fewer than 33 citations for violating federal and state standards in just the last ten months. This was done in Hill's best interests, county officials say.
Now the very-best-case scenario she can hope for is that guardianship will be transferred to a loved one. Family and friends including Houston's prominent, well-heeled Liddell family, which for many years employed Hill as its housekeeper have spent weeks butting heads with bureaucrats in an expensive, unsuccessful effort to reclaim her independence.
"My mother doesn't need this," says Marvin Evans, Hill's son. "It's like the county just swooped in and snatched her away."
Forbidden from leaving Lexington Place, Hill almost never goes out of her room. The dank, sour-smelling corridors constantly crowded with elderly men and women staring blankly from their wheelchairs only further depress her.
So she lies in bed and waits. She waits for meals and baths, afternoon soap operas and visits from family and friends. But, mostly, she waits to get the hell out.
"Home," she moans in a quiet, plaintive voice, stretching the vowel into an agonizing ohhhhh, as if the word itself inflicts pain. "I want to go home."
For 16 years Margie Hill and Marvin Evans have shared a small walk-up apartment just west of the Heights. The second-floor entryway is thick with potted and hanging plants. Inside, it's comfortable and warm with teal carpet, cloth couches and scores of framed photographs on the tables, mantels and walls.
Like his mother, Evans graduated from Booker T. Washington High School, dubbed the oldest black school in Texas. He served two years in the army then returned to Houston to work at various jobs in local hospitals, including a long stint as a mental health technician for Harris County.
Also like his mother, Evans has several health problems. Unemployed for many years, he suffers from chronic back pain and depression. He keeps a heating pad on his bed and a dozen pill bottles beside his pillow.
With a toothpick stuck to his lip, the lanky, stoop-shouldered 54-year-old nonetheless insists, "I'm not so disabled I can't take care of my mama."
Hill's health went south after her stroke ten years ago. She stopped working and frequently fell ill. Evans bathed her, prepared meals and maintained the apartment, which he keeps fastidiously clean and tidy.
Last June, after having some trouble breathing, Hill checked herself into Memorial Hermann Hospital. She was diagnosed with pneumonia and congestive heart failure.
Since Evans doesn't drive, he walked nearly three miles several times a week to visit.
Hospital officials claim they eventually contacted Evans and informed him that his mother was ready to be discharged, but he never showed. Evans denies this.
At the end of the month Hill was transferred to a skilled nursing facility. Evans visited her there, too, though less frequently because it was farther away and harder for him to reach.
Administrators at Memorial Hermann Continuing Care tried to contact Evans but his phone was disconnected. So they reported to Harris County Probate Court that Hill had been abandoned.
On September 1 Dr. Stanton Moldovan recommended the court appoint a guardian, citing Hill's heart failure, diabetes and dementia. Moldovan labeled her mentally incompetent and "totally without capacity."
Indeed, throughout county records, Hill is described as "An Incapacitated Person," "Incapacitated" or, simply, "Incap."
Two weeks later, the court appointed licensed social worker Anthi Pavlicek to investigate. Pavlicek recommended the county take permanent guardianship even though "Margie Hill did not think it was necessary," according to her report. Hill made the same appeal to Josette LeDoux, her attorney ad litem.
Hill's resistance is significant, since before appointing a guardian, a judge must "give due consideration to the preference indicated by the incapacitated person," according to Section 689 of the Texas Probate Code.
On October 10 the probate court referred Hill to the Harris County Guardianship Program. It's one of just two county-run guardianship programs in Texas; the other is in Galveston.
Administered by Harris County Protective Services for Children and Adults, the program has a $2.6 million annual operating budget and employs 37 case managers to oversee more than 1,400 wards. Forty percent of the county's wards are over 60; one-third reside in nursing homes.
On October 20 Harris County assistant attorney Scott Hilsher sent Evans a certified letter. "Unless you take some action to intervene," Hilsher wrote, "this matter will be set for hearing...without further notice to you."
Four days later the Harris County Guardianship Program likewise sent Evans a certified letter informing him of the hearing that would decide his mother's fate.
Both letters returned to the county unopened; notices of delivery were unsigned.
"I got no letter, nothing," Evans says. "Why can they penalize me and take my mama away when I didn't ever know?"
What about the calls from the hospital telling him to pick up his mother?
"Aw, no," Evans counters. "No, no, no. Nah, nah. It didn't happen like that."
Evans claims he went to get his mother but the hospital just gave him papers to sign and would not release her.
Of course, it's possible that the son's account is not totally reliable.
"This wasn't a case of miscommunication," thunders Jan McLaughlin, director of the Harris County Guardianship Program. "The son had ample opportunity to come and get her."
On November 3 Hill was transferred to Lexington Place, where she says she unknowingly forfeited her monthly $826 Social Security check to the facility.
"I didn't read a thing," Hill says. "I didn't know what I was signing."
Evans says the lost income led to his phone being disconnected. He overdrew his bank account and feared eviction for falling behind on rent.
County officials have made some negative assumptions about Evans, despite the many years he provided for his mother.
"Some family members don't want to care for elderly relatives," suggests Estella Olguin, community relations director for Harris County Protective Services, regarding the case. "Then they realize they have to pay their own bills."
On December 12, six floors above downtown Houston in the Harris County Civil Justice building, Probate Court One Judge Russell Austin ignored Hill's pleas and officially declared her a ward. The hearing lasted maybe ten minutes. Neither Hill nor any of her family or friends attended.
Though it's easy to bitch about bumbling bureaucrats, it would seem in this case county officials followed protocol and did everything they were supposed to. Except they screwed up.
It isn't enough that the Harris County Guardianship Program mailed a single certified letter to Evans. The county, by law, must send such letters to "all adult children of a proposed ward," according to Section 633(d)(1) of the Texas Probate Code.
County officials, including McLaughlin, know Hill has three adult children: sons Marvin and Wilbert Evans and daughter Maxine Hill. County social worker Elizabeth Pena filed an "Affidavit of Effort to Locate Family" with the probate court that included all three names.
The county can be forgiven for not informing Wilbert Evans, who hasn't been seen by the family for 30 years. Maxine Hill, however, lives with her husband and child in Mansfield, Louisiana.
Pena recalls her meetings with Hill: "Every time I visited her, she cried." Pena also remembers being told about Maxine Hill living "somewhere in Louisiana," but claims that despite her best efforts she could not locate the daughter.
Pena's attempts must have been halfhearted at best since Maxine Hill can be readily found via a simple phone call to 4-1-1 directory assistance. Hers is the lone name that registers in a statewide search.
"We didn't know that," says McLaughlin, when informed by the Press.
Maxine Hill, a 49-year-old restaurant manager, was outraged when she learned her mother was made a ward. Had she been informed, she never would have let it happen.
"Mama always told me she didn't want to be put in no nursing home," she says. "I don't understand why they done it. I mean, I could see if she didn't have nobody else."
Growing up in one of Houston's most upscale neighborhoods, attending an elite private high school and socializing at exclusive country clubs has its disadvantages.
"Our world was insular and homogenized," says 36-year-old Robert Liddell, whose father Frank was a legendary trial lawyer and remains a partner at mega-firm Locke Liddell & Sapp LLP. "We pretty much got one perspective."
Margie Hill, hired as the family's housekeeper in 1976, opened their eyes to a life beyond their privileged upbringing. After all, the Liddell children were more likely to encounter a UFO than an African-American woman living paycheck-to-paycheck in a rental apartment.
Hill arrived at the family's 7,500-square-foot Tanglewood mansion widowed and in her early 40s. It was the first and only job she ever held. She stayed on for two decades and became a beloved member of the Liddell family.
Lise Putnam Liddell, the family's 71-year-old matriarch, describes Hill as hardworking, trustworthy and proud. "She had a dignity about her that you don't see often," she says.
Her 44-year-old daughter, a local singer and songwriter also named Lise, remembers Hill as lighthearted, gregarious and always fashionably dressed. "She'd hug us all the time and chide us when we needed it," she says.
Robert Liddell, now an adjunct English professor at Houston Community College, credits Hill for helping him get through his parents' protracted divorce. "She was a source of stability at a time that was troubled." he says. "She could have simply done a job and gone home. But she chose to care."
Hill still refers to Robert Liddell as her baby. His graduation picture from The Kinkaid School is prominently displayed on her living room wall.
Though Hill could no longer work after her stroke, Lise Putnam Liddell continued to provide her $800 a month. Her children gladly assumed this responsibility a couple years ago. Added to her social security check, the money afforded Hill and her son a modestly comfortable life.
As he often does around the holidays, Robert Liddell called Hill one day last fall. The phone was disconnected; he figured she missed a payment.
His sister Lise kept calling during the next several weeks. Worried, she decided to pay Hill a visit just before Christmas.
She ascended the stairs to Hill's apartment and rapped at the door. Evans invited her in, collapsed on a couch and broke into sobs. His mother had been taken away and he didn't understand why, he told her.
Evans explained that he had recently visited his mother at Lexington Place. He said administrator Thelma Broussard informed him that Lexington Place was her new home and that any questions should be addressed to the county.
This exchange occurred a week before Hill became a ward, according to county records.
Lise Liddell felt mortified and partially responsible for not acting sooner. She did not understand how this could have happened. She called her father, whose firm retains 400 attorneys. But they specialize in corporate law and anyway, offices were already shuttered for the holidays.
She went to Lexington Place to visit Hill, who immediately held out her arms and cried. Broussard confirmed the situation. "You have to call the county," she said, and provided a number to Hill's caseworker. Lise Liddell later complained to Broussard that the number went straight to voice mail with the message that the caseworker was away on vacation until January 2. Broussard's response: "You have to keep trying."
After the holidays, the Liddells retained attorney Bridget O'Toole Purdie from Bracewell & Giuliani LLP, who warned that the county may deny guardianship to Evans due to his health problems. Instead, she advised that the Liddells seek guardianship themselves.
So on January 9, after obtaining signed notarized statements from two of Hill's children, Lise Liddell filed a successor guardianship application with the probate court. As guardian, she would be responsible for Hill's health and finances. Medicare, she has learned, should cover sending a home health aide to look after Hill a few times a week.
The Liddells have visited Hill at Lexington Place almost every day for the last month. They bought Evans a new phone and padded his bank account to cover rent, utilities and day-to-day expenses.
"This should not be happening to Margie," Lise Putnam Liddell says. "We'll do whatever it takes to get her out."
In the case of Margie Hill, transferring guardianship to her loved ones should be a no-brainer.
After all, indigent guardianship programs are meant to serve those with no other options, says Terry Hammond, an El Paso-based attorney whose firm is devoted entirely to guardianship issues.
"From a good guardianship perspective, the priority should definitely be placed on those closest to the person who needs the assistance," says Hammond, who also serves as executive director of the National Guardianship Association, Inc. "Why should taxpayers be paying to finance a guardianship where there's someone willing to come in and do it for free?"
Jan McLaughlin, the Harris County Guardianship Program director, says she is "always supportive" of wards reuniting with their families. "I'm sorry that the family is in this predicament," McLaughlin says. "I understand the family is distressed."
Such condolences ring hollow since McLaughlin refuses to request an expedited hearing to transfer guardianship. "It's the court's decision," she says. "It needs to go through all the appropriate channels."
That could take several more weeks, maybe even months.
"Guardianship can be a lot easier to get into than to get out of," says Hammond, adding that contested guardianship cases can easily cost families more than $20,000. "Some family members just throw up their arms and say, 'You know, I cannot take on the government in trying to get control of my loved one's affairs.'"
Hill landed herself in this situation simply by getting sick. Oftentimes that's all it takes, according to Sara Aravanis, director of the National Center on Elder Abuse.
"Hospitalization is a significant turning point for many, many people," Aravanis says. "It brings more people into the situation, for good or for bad. There are more sentinels asking, 'Can this person's life be improved?'"
The probate court recently appointed LeDoux, formerly Hill's attorney ad litem, to now serve as her guardian ad litem.
The distinction between attorney ad litem and guardian ad litem is significant.
An attorney ad litem is charged with representing the proposed ward's interests to the court. A guardian ad litem, meanwhile, makes the all-important recommendation for who should assume guardianship.
The question is whether LeDoux's appointment as guardian ad litem presents a conflict of interest since she may have developed biases while formerly serving as Hill's attorney.
McLaughlin rejects this, saying LeDoux was named guardian ad litem to speed the process along since she already knew the facts of the case.
Reached by phone, LeDoux declined to comment on the status of her investigation as it is ongoing.
While LeDoux conducts interviews, runs criminal background checks and files the requisite paperwork, Hill remains warehoused at Lexington Place -- a facility not merely soul-killing but also physically dangerous.
Opened in 1967, Lexington Place is owned by Pinnacle Health Facilities, which operates a total of three nursing homes in Harris County and accepts residents insured by Medicare and Medicaid.
During the last year, state investigators have issued dozens of citations against Lexington Place for everything from patient neglect to fire-safety hazards, according to records from the Texas Department of Aging and Disability Services, which licenses and oversees the state's 1,122 private nursing homes.
Perhaps most distressing were citations given last March for failing to store poisons separately from all drugs and for not properly caring for residents needing special services such as injections, colostomies and respiratory care.
Lexington Place "failed to provide a safe and clean environment for residents, staff and visitors," according to the state's most recent report, filed in November 2006. "There were some deficiencies that caused residents actual harm or immediate jeopardy."
Hill has her own litany of complaints.
For one thing, she receives scant attention from nurses. "Nobody comes see about me," she groans. At home, Hill bathed every day. Lexington Place permits just two showers a week. For the last week, Hill says, the water heater has been broken and everyone is taking cold showers. And the food is awful. Spoiled by years of her son's homemade gumbo and slow-roasted chicken, she now picks at plates of cornbread and beans or boiled cabbage and fish sticks.
During a recent visit, Lise Liddell's friend offered to bring lunch. Hill requested a cheeseburger with all the fixings. It was the first meal she finished in weeks.
Marvin Evans often fantasizes about marching into Lexington Place, hoisting his mother out of bed, flagging a cab and taking her home.
"But I'm afraid they'll throw me in jail," he says.
His fear is justified; interference in the possession of a ward is a felony-level offense.
Evans is grateful for the financial help he receives from the Liddells. Without it, he figures his mother would have no choice but to spend her last years at Lexington Place.
The Liddells are paying their attorney a whopping $380 an hour to handle the case. Clearly many families lack the resources necessary to grapple with the county.
"We're repaying a debt," says Robert Liddell, who plans to continue to support Evans if he outlives his mother. "She was somebody who was always there when we needed her."
Maxine Hill says her mother is welcome to live with her in Louisiana. But she decided to let the Liddells seek guardianship so her mother and brother can continue to care for one another in their own place.
Evans is hopeful his mother will return home soon. He continues to visit her at Lexington Place almost every day.
But he worries about her resolve. Never before has she appeared so dejected.
For Christmas, Evans always decorates their apartment with lights, tinsel and a six-foot-tall artificial tree and prepares a small feast. This year he sat alone in his darkened bedroom, atop his heating pad, and downed a bacon and egg sandwich on plain white bread.
"I lost the spirit; what can I say, my Christmas spirit just went out the door," he says.
His mother, too, stayed in bed: "For the holiday I did nothing but lie here."
On New Year's Eve mother and son usually stay up late together and toast the season with a glass of bubbly. This year both turned in early.
Hill has anxiously waited to leave Lexington Place since she arrived nearly three months ago. She has waited through several holidays, from Thanksgiving to Martin Luther King Jr. day.
This Wednesday Hill turns 77. She's still waiting.
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