It's been one year since Jim Crochet became Florida's long-term care ombudsman, head watchdog of the program charged with protecting the rights of nursing home and long-term care residents statewide.
It's been a tough year.
In February, soon after Gov. Rick Scott took office, he dismissed the previous ombudsman, Brian Lee, who had served for seven years and was considered a thorn in the side of providers as were some of his volunteers.
Secretary Charles Corley of the Department of Elder Affairs, which houses the ombudsman program, ousted Lee, who has since filed a lawsuit now before Leon County Circuit Judge James O. Shelfer. The suit is emerging as a clash over the ability of the long-term care industry to influence who regulates its facilities.
What's more, two of Lee's closest volunteer supporters were also dismissed by the program, shortly after Lee left, for emails that allegedly violated Florida's open meetings law, and a federal report then found the state had violated the Older Americans Act by "muzzling" the ombudsman program.
"I was in love with the program," said Win Hoffman, one of the two "de-designated" volunteers. "But politics being what it is, that seems to be the overriding concern when you're dealing with a state agency."
Hoffman was the 2010 Ombudsman of the Year for Broward County before his dismissal, which came after he collaborated with the Miami Herald and WLRN-FM, its public radio affiliate, on a series that exposed deaths from abuse and neglect at the state's assisted living facilities.
The ombudsman program is staffed by volunteers who go into nursing homes and ALFs, listen to complaints from residents and try to solve their problems. They're adapting now to a new direction in their work since Crochet formerly a DOEA rule-writer took Lee's place.
And some say the program must adapt when the governor's office changes hands.
"Many industry people felt we were serving a role that was already served by other agencies, and I think that's true," said Carol Weideman of Pinellas County, a volunteer for 11 years and chair of the state council for volunteer ombudsman.
Weideman backs the program's new direction, which Crochet describes as advocacy rather than regulation.
Crochet has revised the assessment form the volunteers fill out at each facility. It's no longer a checklist, he said, which he felt required volunteers to be regulators instead of advocates. Now the volunteers don't check the temperature in a facility's kitchen refrigerator unless a resident complains.
"We've worked with the industry representatives to let them know, 'We don't consider you the enemy,'" said Crochet. "If you're part of the problem, you're going to be part of the solution. Unless you tell us you don't want to cooperate. Then we're moving on and we're going to take out the big guns and call [the Agency for Health Care Administration]."
The ombudsman program is charged with visiting the state's 4,000 ALFs once a year, while AHCA must visit them once every two years. Among Crochet's first-year accomplishments: an online training program and a library, a recruitment program for state retirees and college interns and the new assessment tool.
"I think one of my district managers says it the best way: 'It's cheaper to deal with me than with AHCA, because they can fine you,'" Crochet said. "We really are trying to work with everyone to make the lives of that resident better. We never give up."
But state Sen. Eleanor Sobel, D-Hollywood, said the residents are often too frail or mentally diminished to confide in an advocate.
"I have an aunt who's 91 in an ALF," Sobel said. "No way would I know if someone mistreated her. She couldn't even tell me that."
Lee said the change in assessing the facilities is driven by those who own and operate them.
"The industry didn't like that we put our residents above them," Lee said. "If the residents see that there's a conflict of interest, they're not going to reach out to the ombudsman program."
In court, representatives of Florida's nursing homes and ALFs argued that Lee's suit would deprive the industry of its rights, particularly to petition the government for a redress of grievances.
His attorney said the law protecting ombudsmen's independence applied, while Lee and his supporters argue for a role outside any state agency.
"The industry threatens through interference, retaliation and intimidation to stop the ombudsmen's advocacy work," Lee said.
The 300 volunteer ombudsmen statewide are mostly retired professionals. Jeanne Anastasi of Poinciana, in Polk County, is one. She worked for the state of Maryland for 20 years, ending as director of its Office of Adult Protective Services, and has taken the ombudsman program's change of leadership in stride.
"Let's face it, one day we're all going to be older," Anastasi said. "I want this program to be there for my own personal reasons."
Whatever their philosophy regulation or advocacy the volunteers agree on their commitment to the residents.
"They can really be taken advantage of," said Carol Weideman, who adds that she wasn't surprised by the revelations in the Herald series.
"It really seemed like the facilities we thought were the worst never got shut down."