The Issue Whether Petitioner should be granted the exemption from disqualification from employment that she is seeking.
Findings Of Fact Based upon the evidence adduced at hearing and the record as a whole, the following findings of fact are made: In 1975, when she was 36 years of age, Petitioner was dating a married man. When the man's wife found out about her husband's extramarital affair, she began to harass Petitioner and members of Petitioner's family. On March 4, 1975, Petitioner was sitting in her vehicle with her then 17-year old son in the driveway of her home. She was about to leave to take her son to work when her boyfriend's wife drove up and blocked the driveway. Petitioner's son got out of the car and asked the wife to move her vehicle. The wife responded by making what Petitioner perceived to be an "ugly" gesture that was directed to Petitioner's son. Petitioner reacted in anger to the wife's response. She exited her vehicle and physically attacked the wife, bloodying the wife's nose. Police officers arrived on the scene and arrested Petitioner. Petitioner was charged with, and on April 22, 1975, convicted of, aggravated assault as a result of this March 4, 1975, incident. As punishment for committing this crime, she was directed to pay a $50.00 fine and court costs. Petitioner recognizes that her physically aggressive behavior on March 4, 1975, was inappropriate. She is remorseful and repentant. Petitioner has not committed any similar unlawful acts of violence in the more than 22 years since the March 4, 1975, incident. In 1980, Petitioner was arrested and charged with two counts of resisting a law enforcement officer without violence after she had intervened in an altercation involving her son and several police officers, but the charges against her were ultimately dismissed. Petitioner is a certified nursing assistant. She began working as nursing assistant approximately 30 years ago. As a nursing assistant, Petitioner has assisted individuals (in their homes and in institutional settings) needing help in performing their activities of daily living. She has provided such assistance without incident, notwithstanding that she has had to care for some individuals who have been quite difficult, including certain residents of South Florida State Hospital, a state-operated mental health facility, where she worked from 1981 through 1991 (as an employee of two different private nursing agencies with whom the hospital had contracted to provide nursing assistant services) and from January 24, 1997, to July 23, 1997 (as an employee of the hospital).2 There were occasions during the time she worked at South Florida State Hospital that residents would become physically aggressive toward her. On these occasions, Petitioner reacted, not in kind, but rather with restraint and in a professional manner. On July 23, 1997, after a background screening investigation conducted by the Department had revealed that she was not qualified to serve in her position at South Florida State because of her 1975 conviction for aggravated assault, and following the Department's preliminary denial of her request for an exemption from such disqualification, Petitioner was terminated from her position at the hospital. Petitioner has been unemployed since July 23, 1997. Although she has been unable to find work as a nursing assistant, Petitioner still continues to perform nursing assistant services (without compensation) for her elderly aunt, for whom she has cared for the past five years. Based upon Petitioner's history since the March 4, 1975, incident that led to her arrest and conviction for aggravated assault, it appears that she has rehabilitated herself and that she will not present a danger if her exemption request is granted.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Department issue a final order granting the exemption that Petitioner has requested. DONE AND ENTERED this 22nd day of October, 1997, in Tallahassee, Leon County, Florida. STUART M. LERNER Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (904) 488-9675 SUNCOM 278-9675 Fax Filing (904) 921-6847 Filed with the Clerk of the Division of Administrative Hearings this 22nd day of October, 1997.
The Issue Respondent is charged under Section 464.018(1)(c), Florida Statutes, of being convicted, regardless of adjudication, of a crime which directly relates to the practice of nursing or the ability to practice nursing, and under Section 464.018(1)(d) 5, of being found guilty, regardless of adjudication, of a violation of Chapter 784, Florida Statutes, relating to assault, battery, and culpable negligence.
Findings Of Fact The Respondent is, and at all times material hereto has been, a licensed registered nurse in the state of Florida, having been issued license number RN 1931082. She has been licensed in one or more states as a nurse for 25 years. She has been a critical care nurse and worked emergency rooms and ambulances. She has never before been the subject of Florida license discipline. On March 15, 1995, Respondent was charged with the crime of vehicular homicide, a second degree felony, pursuant to Section 782.071, Florida Statutes (1993). (See Exhibit R-5 showing the statutory year.) That statute provided in pertinent part, 782.071 Vehicular homicide. -- "Vehicular homicide" is the killing of a human being by the operation of a motor vehicle by another in a reckless manner likely to cause death of, or great bodily harm to, another. Vehicular homicide is a felony of the third degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. Any person who commits vehicular homicide and willfully fails to stop or comply with the requirements of s. 316.027(1) is guilty of a felony of the second degree, punishable as provided in s. 774.082, s. 775.083, or s. 775.084 Respondent pled "not guilty" to the charge of vehicular homicide. On May 30, 1996, Respondent was tried and found guilty by a jury of vehicular homicide, in the Circuit Court in and for Manatee County, Florida under Case No. 94-3739F. A charge against Respondent of leaving the scene of the accident was dropped at trial. On June 27, 1996, Respondent was sentenced to six-and- one-half years of imprisonment followed by eight years of probation. The Second District Court of Appeal affirmed the Respondent's conviction, but her sentence was recalculated in connection with the applicable sentencing guidelines. There have been no other appellate decisions regarding Respondent's conviction. Respondent was due for work release shortly after formal hearing. The Respondent testified that she considered it her obligation as a nurse to stop and render assistance if she knew she hit someone with a motor vehicle; however, Respondent maintained that she did not know that she had hit anyone. The Agency presented no testimony, expert or otherwise, to relate Respondent's second degree felony conviction of vehicular homicide to the practice of nursing or the ability to practice nursing.
Recommendation Upon the foregoing findings of fact and conclusions of law, it is RECOMMENDED that the Department of Health, Board of Nursing enter a Final Order finding Respondent not guilty of both counts of the Administrative Complaint and dismissing the Administrative Complaint. DONE AND ENTERED this 8th day of May, 1998, in Tallahassee, Leon County, Florida. ELLA JANE P. DAVIS Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 Filed with the Clerk of the Division of Administrative Hearings this 8th day of May, 1998.
The Issue The issue presented here concerns the jurisdiction of the Respondent State of Florida, Department of Health and Rehabilitative Services, to pass on the issue of whether the Petitioner, John Jackson, meets the definition of sex offender within the meaning of Chapter 917, Florida Statutes; it having been determined that the Department has exhausted all treatment for the Petitioner. Secondarily, this Recommended Order considers the question of whether the Petitioner can, through the process of this administrative hearing, controvert the clinical summary dated October 13, 1980, by challenging the findings of that report, even if it has been determined that the Department has exhausted all treatment for the Petitioner and the Department is without jurisdiction to enter a final order on the question of whether the Petitioner meets the definition of sex offender within the meaning of Chapter 917, Florida Statutes. Of particular interest on the secondary issue is that part of the report which indicates that the Petitioner still meets the definition of sex offender.
Findings Of Fact The Petitioner submitted a "Petition for Administrative Determination" to the State of Florida, Department of Health and Rehabilitative Services. In turn, the Department requested the Division of Administrative Hearings to conduct a formal hearing to consider the matters set forth in the Petition and this request was received by the Division of Administrative Hearings on January 5, 1981. Specifically, the Petition asked that a Subsection 120.57(1), Florida Statutes, hearing be conducted to consider the question of whether the Respondent State of Florida, Department of Health and Rehabilitative Services has exhausted all appropriate treatment for the Petitioner John Jackson, who was enrolled in one of the Respondent's sex offender programs at Florida State Hospital, Chattahoochee, Florida. The prayer for relief offered by the Petitioner was in keeping with the language of Section 917.20, Florida Statutes (1977), which states: . . . if the department returns an offender to the court because the department has determined that it has exhausted all treatment of the offender, the court shall remove the offender from the custody of the department. A continuance of the formal hearing scheduled for January 30, 1981, was granted and the final hearing was eventually held on March 3, 1981. At the commencement of the hearing, counsel for the Petitioner promoted a substantial change to the Petitioner's claim for relief. That change was one which conceded the dispute fashioned in the details of the "Petition for Administrative Hearing," in that the Petitioner and Respondent agree that the Respondent had exhausted all appropriate treatment for the Petitioner through the programs for sex offenders offered in the State of Florida. The Petitioner then attempted to amend his Petition to request that a final order be entered by the Secretary, Department of Health and Rehabilitative Services which decided if the Petitioner continued to meet the definition of sex offender found in Chapter 917, Florida Statutes. Additionally, the Petitioner, in the person of his counsel, attempted to amend the Petition to attack the details of the staff report of October 13, 1980, dealing with the status of the Petitioner's condition with particular emphasis on the finding that Jackson continued to he a sex offender. The Respondent was opposed to the amendment on the ground of lack of jurisdiction on the part of the Respondent to consider these claims, it having been determined that the Respondent had exhausted treatment for the Petitioner and moreover, the Respondent objected to the change in the Petition which did not grant the Respondent sufficient notice to prepare to defend against the accusations. The Respondent's position was found to be meritorious and the reasons for that decision will be discussed in the Conclusions of Law section of this Recommended Order.
The Issue The issue in this case is whether the allegations set forth in the First Corrected Amended Administrative Complaint filed by the Department of Health (Petitioner) against Deshon A. Davis, CNA (Respondent), are correct, and, if so, what penalty should be imposed.
Findings Of Fact The Petitioner is the state agency charged by statute with regulating the practice of nursing assistance. At all times material to this case, the Respondent was licensed as a CNA in the State of Florida, holding license no. CNA 274735. At all times material to this case, the Respondent was employed as a CNA by Health First Cape Canaveral Hospital (hereinafter “Hospital”) in Cocoa Beach, Florida. On April 23, 2014, Patient K.H. (hereinafter “patient”) was admitted to the Hospital. The patient was discharged from the Hospital on May 1, 2014. During the time the patient was admitted to the Hospital, he was able to speak; able to get out of his bed and exit the room; and able to use the bathroom without assistance. On April 25, 2014, the patient contacted Hospital authorities and reported that on the two previous days, the Respondent had committed sexual misconduct. At the hearing, the patient testified that on April 23, 2014, the Respondent entered the room and stated that he needed to bathe the patient. The Respondent testified that the patient had soiled his clothing, and that he entered the room to remove the clothing, clean the patient, and provide fresh clothing to the patient. At the time, the patient was in a semi-private room, with another patient in the other bed. The Respondent pulled the privacy curtain around the patient’s bed to separate the beds and to shield the patient from view. The patient testified that the Respondent removed the patient’s clothing, applied an unidentified lotion to the patient’s penis, and roughly manipulated the patient’s penis in a masturbatory manner for at least five minutes until the patient ejaculated. The patient testified that the Respondent then exited the room, leaving the patient to wipe off the ejaculate. Although the patient testified that he requested that the Respondent cease the manipulation, the patient made no apparent effort to get out of the bed or to contact anyone for assistance during the alleged event. The Respondent denied that he applied a lotion to the patient’s penis or that any sexual contact occurred on April 23, 2014. The Respondent testified that while he was cleaning the patient, he observed a “rash” on the patient’s thigh, and that he applied a “barrier cream” to the rash. Although the Respondent testified that he informed the Hospital nursing staff about the rash on April 23, 2014, the registered nurses assigned to care for the patient testified that they had no recollection that the Respondent advised them that the patient had a rash. The patient’s medical records contain no documentation of a rash or of the application of any medication related to a rash. No nurse approved or directed the application of any substance to the patient for a rash. The patient testified that the second incident occurred on or about April 24, 2014. Although the patient had been moved to another semi-private room, only the Respondent and the patient were present in the room at the time of the alleged event. The patient testified that the Respondent entered the room, made a comment about the patient “bringing in rashes,” exposed the patient’s genital area, and then again, after applying a lotion to his penis, roughly manipulated the patient’s penis in a masturbatory manner for approximately ten minutes until the patient ejaculated. The patient testified that the Respondent left the room, and the patient had to again clean himself. Again, although the patient testified that he asked the Respondent to cease the sexual manipulation, the patient made no apparent effort to get out of the bed or to contact anyone for assistance. The Respondent denied the alleged sexual contact. The Respondent testified that he entered the patient’s room because the patient’s “call light” was on. The Respondent testified he heard the patient say “ouch” while using a plastic urinal. The Respondent testified that he thereafter observed a “cut” on the patient’s penis. He also testified that the thigh rash was still visible. The Respondent suggested that abrasions caused by plastic urinals are not uncommon. There is no credible evidence that the patient’s penis was injured on April 24, 2014, whether by a plastic urinal or otherwise. The Respondent testified that after he obtained the patient’s consent, he applied the “barrier cream” to the patient’s penis and thigh. There is no evidence that the Respondent advised the Hospital nursing staff about any injury to the patient’s penis. The patient’s medical records contain no documentation of a wound or abrasion on the patient’s penis or of a rash on his thigh. No nurse approved or directed the application of any substance to the patient for a wound or a rash. On April 25, 2014, the patient contacted Hospital authorities and reported the alleged sexual improprieties. The patient’s medical records indicate that from the time of the patient’s Hospital admission on April 23, 2014, until April 25, 2014, the patient had been resting and calm. According to the Hospital’s representatives who spoke to the patient on April 25, 2014, he was emotional and “very distraught” while describing the alleged activities. A physical examination of the patient was conducted on April 25, 2014, during which no visible rash on the thigh or injury to the penis was observed. According to the expert testimony of Lynda Tiefel, R.N., a CNA must report the presence of a wound or a rash on a patient to a registered nurse. It is the responsibility of the registered nurse to assess the condition and determine whether a physician referral should occur. Other than reporting the condition to the nurse, a CNA should take no action unless directed to do so by the nurse. Ms. Tiefel’s testimony was persuasive and has been credited. According to the expert testimony of Victor Mendez, C.N.A., a CNA is not qualified to diagnose a medical condition. A CNA is required to document the presence of a rash or wound, and advise the appropriate registered nurse of the condition. The CNA may apply medication to a rash or wound only after receiving direction to do so from the registered nurse, and such application should take no more than 15 seconds. Mr. Mendez’s testimony was persuasive and has been credited. The Hospital conducted an internal investigation regarding the allegations, and subsequently terminated the Respondent’s employment.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is recommended that the Department of Health, Board of Nursing, enter a final order: finding the Respondent guilty of violating sections 464.204(1)(b) and 456.072(1)(o); placing the Respondent on probation for a period of one year, during which the Respondent shall complete such continuing education courses as specified by the Petitioner; and imposing an administrative fine of $125.00. DONE AND ENTERED this 11th day of September, 2015, in Tallahassee, Leon County, Florida. S WILLIAM F. QUATTLEBAUM Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 11th day of September, 2015. COPIES FURNISHED: Deshon A. Davis, C.N.A. 3620 East Powder Horn Road Titusville, Florida 32796 Lucas Lawrence May, Esquire Department of Health Prosecution Services Unit Bin C-65 4052 Bald Cypress Way Tallahassee, Florida 32399 (eServed) Judson Searcy, Esquire Department of Health Prosecution Services Unit Bin C-65 4052 Bald Cypress Way Tallahassee, Florida 32399 (eServed) Ann L. Prescott, Esquire Department of Health Bin C-65 4052 Bald Cypress Way Tallahassee, Florida 32399 (eServed) Jamison Jessup, Qualified Representative 557 Noremac Avenue Deltona, Florida 32738 (eServed) Joe Baker, Jr., Executive Director Board of Nursing Department of Health Bin C-02 4052 Bald Cypress Way Tallahassee, Florida 32399 (eServed) Ann-Lynn Denker, PhD, ARNP, Chair Board of Nursing Department of Health Bin C-02 4052 Bald Cypress Way Tallahassee, Florida 32399
The Issue The issue in this case is whether Respondent, Stephen H. Rosenthal, committed the offenses alleged in an Administrative Complaint issued on or about December 22, 1999, by Petitioner, Tom Gallagher, as Commissioner of Education and, if so, what penalty should be imposed upon Respondent.
Findings Of Fact Respondent, Stephen Rosenthal, holds a valid Florida Educator's Certificate, Number 644646. Respondent's Certificate covers the areas of Elementary Education and Mathematics and is valid through June 30, 2001. At all times relevant to this matter, Respondent was employed as a fifth-grade teacher at Manatee Elementary School, an elementary school in the St. Lucie County School District. During the fall of 1997 Paul E. Griffeth, a detective with the Port St. Lucie Police Department, was informed that Respondent had been in contact through the internet with a detective of the Keene, New Hampshire Police Department, that Respondent believed that he was communicating with a minor, and that Respondent had sent the Keene detective pornographic pictures via the Internet. Based upon the information Officer Griffeth received, a search warrant was obtained. The search warrant authorized a search of an address where Respondent was believed to reside. Officer Griffeth, Todd Schrader, then a detective with the Port St. Lucie Police Department, and a Detective Calabrese attempted to execute the search warrant. When they served the search warrant on Respondent they learned that Respondent no longer lived at the address identified in the search warrant. Respondent informed Detectives Schrader and Griffeth of his new residence address and agreed to allow them to search his residence without obtaining a new warrant. Respondent inquired into the reason for the search warrant and was told that it was believed that he was suspected of having sent child pornography on the internet and of having files on his computer and computer disks in his residence that contained child pornography. Respondent initially denied these allegations. Detective Schrader asked Respondent if he knew who "Luke 14" was. Respondent admitted that he believed that "Luke 14" was a 14-year-old male. Detective Schrader told Respondent that "Luke 14" was a police detective. Respondent shook his head and said, "No, no." Respondent later admitted that he had sent pornographic pictures, including pictures of Respondent naked, to "Luke 14," believing he was a 14-year-old boy. Respondent then admitted to Detective Schrader that he had a number of pictures that he had downloaded from the internet and acknowledged that some of the pictures could be construed as child pornography. Respondent also admitted that he had numerous diskettes with pictures of minors that he had downloaded from the internet. When the detectives entered Respondent's residence, they found two pictures of two individual nude males, with their genitalia exposed, which the detectives believed to be between the ages of 12 to 16. Respondent admitted that he believed that that was the age of the boys. Respondent also admitted that he had downloaded the pictures off the internet and that he had printed them. A number of diskettes were found at Respondent's residence which contained pictures of males with their genitalia exposed. Although some of the males pictured appeared to be minors, the evidence failed to prove that they were in fact pictures of minors. 1/ On November 3, 1997, Respondent was arrested. He was charged in an Indictment filed before the United States District Court for the Southern District of Florida (hereinafter referred to as the "U.S. District Court") with eight counts of Knowingly Receiving a Visual Depiction of a Minor Engaged in Sexually Explicit Conduct that had been transported and shipped in Interstate Commerce by Computer and one count of Having Possession of Three or More Visual Depictions of a Minor Engaged in Sexually Explicit Conduct that had been transported and shipped in Interstate Commerce by Computer. In March 1998 Respondent entered into a Plea Agreement in the U.S. District Court, agreeing, in part, to the following: The [Respondent] agrees to plead guilty to Counts 1 and 3 of the Indictment, which charges the defendant with the knowing receipt of child pornography in interstate commerce by computer, that is, visual depictions of minors engaged in sexual conduct . . . . The [Respondent] admits that he is, in fact, guilty of this offense. On March 12, 1998, Respondent appeared before the Honorable James C. Paine, United States District Court Judge for the Southern District of Florida. Respondent was questioned extensively concerning the Plea Agreement and Respondent's understanding of the charges to which he had admitted. During this proceeding, the essential facts relating to Counts 1 and 3 were summarized and Respondent was asked whether he agreed with those facts. Respondent agreed with all the summarized facts; except the allegation that he thought that Luke 14 was a minor. 2/ Among the summarized facts which Respondent admitted to are the following: That Respondent knowingly received a visual depiction; the visual depiction was shipped or transported by interstate commerce by any means, including computer; that the visual depiction was of a minor engaged in sexually explicit conduct; and that Respondent knew that the visual depiction was of a minor engaged in sexually explicit conduct; That Respondent sent several sexually explicit pictures to Luke 14. The pictures were of the Respondent, naked; and That Respondent had photographs of two nude minors in his residence. Respondent entered a plea of guilty to Counts 1 and 3 of the Indictment, was adjudicated guilty of the two counts, and was sentenced to 70 months in prison on each Count to run concurrently. The other seven counts were dismissed. The evidence failed to prove that Respondent's plea of guilty was made as the result of any threat, coercion, or fraud. By entering a plea of guilty to Count 1 of the Indictment, Respondent admitted to the following: On or about February 5, 1997, in St. Lucie County, in the Southern District of Florida, the defendant, STEPHEN H. ROSENTHAL, did knowingly receive a visual depiction that had been transported and shipped in interstate commerce by computer . . . depicting a minor engaging in sexually explicit conduct . . . to wit: a depiction of a minor male engaging anal-genital sexual intercourse with an adult male, the production of which involved the use of a minor engaging in sexually explicit conduct. By entering a plea of guilty to Count 3 of the Indictment, Respondent admitted to the following: On or about April 15, 1997, in St. Lucie County, in the Southern District of Florida, the defendant, STEPHEN H. ROSENTHAL, did knowingly receive a visual depiction that had been transported and shipped in interstate commerce by computer . . . depicting minors engaging in sexually explicit conduct . . . to wit: a depiction of two minor males engaging oral-genital sexual intercourse, the production of which involved the use of a minor engaging in sexually explicit conduct. By pleading guilty to Counts 1 and 3 of the Indictment and admitting to Judge Paine that he had committed those offenses, Respondent admitted that he had been in possession of child pornography and that he had downloaded the child pornography from the Internet. Respondent subsequently attempted to withdraw his plea. This effort was rejected. Respondent is currently incarcerated at FCC Coleman serving his 70-month sentence. The arrest and subsequent conviction of Respondent resulted in adverse and widespread publicity in St. Lucie County. Respondent's arrest and conviction and the resulting adverse publicity were sufficiently notorious to disgrace the teaching profession and seriously reduce Respondent's effectiveness as a teacher. Respondent's employment with the St. Lucie County School Board was terminated due to the foregoing incidents. Petitioner issued an Administrative Complaint on or about December 22, 1999, in which Petitioner recommended that the Education Practices Commission impose appropriate disciplinary sanctions on Respondent's educator's certificate pursuant to Sections 231.262 and 231.28, Florida Statutes, and Rule 6B-1.006, Florida Administrative Code, due to the following alleged facts: 3. During the 1996-1997 and 1997-1998 school year, Respondent was in possession of child pornography and down loaded the child pornography from the Internet onto his home computer. On or about November 3, 1997, Respondent was arrested and charged with 8 counts of Knowingly Receiving a Visual Depiction of Minor Engaged in Sexually Explicit Conduct that had been transported and shipped in Interstate Commerce by Computer, and one count of Having Possession of Three or More Visual Depictions of a Minor Engaged in Sexually Explicit Conduct that had been transported and shipped in Interstate Commerce by Computer. On or about June 2, 1998, Respondent pled Guilty to two of the counts of receiving the photographs. The court dismissed all other charges and adjudicated Respondent Guilty on the remaining two. Respondent was sentenced to 70 months on each count to run concurrently, to receive health/psychiatric counseling during incarceration, 3 years of supervised release, not possess a firearm and pay $3200 in fines and fees. On or about November 25, 1997, Respondent was terminated from his position with the St. Lucie County School Board. Respondent filed an unexecuted Election of Rights form and a letter in response to the Administrative Complaint. Although Respondent did not specifically request an administrative hearing, he did dispute the material facts of the Administrative Complaint. The Administrative Complaint and Respondent's letter were filed with the Division of Administrative Hearings on September 19, 2000, with a request that the matter be assigned to an administrative law judge.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that a final order be entered finding that Respondent, Stephen H. Rosenthal, violated Sections 231.28(1)(c) and (f), Florida Statutes. It is further RECOMMENDED that the final order dismiss the charge that Respondent violated Section 231.28(1)(i), Florida Statutes. It is further RECOMMENDED that Respondent's Florida Educator's Certificate, Number 644646, be permanently revoked. DONE AND ENTERED this 10th day of January, 2001, in Tallahassee, Leon County, Florida. LARRY J. SARTIN Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 10th day of January, 2001.
The Issue The issue in this case is whether Petitioner, John Harris, should be granted an exemption from disqualification from employment pursuant to Chapter 435, Florida Statutes.
Findings Of Fact Petitioner, John Harris, was employed at the Florida State Hospital in Chattahoochee, Florida, from October 1977 to January 15, 1998. The Florida State Hospital is a residential facility for mentally ill adults. Mr. Harris was employed as a Unit Treatment and Rehabilitation Specialist. Mr. Harris was involved in the provision of direct care to residents of Florida State Hospital. During 1997 the Department of Children and Family Services (hereinafter referred to as the "Department") pursuant to Chapter 435, Florida Statutes, conducted background screening of employees involved in the provision of direct care to residents of Florida State Hospital. As a result of a background screening check of Mr. Harris, it was determined that Mr. Harris had pled nolo contendere to possession of cocaine, a felony pursuant to Chapter 893, Florida Statutes, in 1989. As a result of the determination that Mr. Harris had pled nolo contendere to a felony under Chapter 893, Florida Statutes, Mr. Harris was notified by the Department that he was disqualified from employment in his position with Florida State Hospital. The following are the pertinent facts concerning the 1989 nolo contendere plea: During the afternoon of September 11, 1989, Mr. Harris was traveling by automobile from Tallahassee, Florida, where he had picked up the automobile from his wife, to Quincy, Florida, where he lived; Mr. Harris was traveling at a speed of 100mph while being chased by law enforcement. He was stopped by other law enforcement personnel waiting for him just outside Quincy; The automobile that Mr. Harris was driving was searched and cocaine was discovered; Mr. Harris was charged with possession of a controlled substance in violation of Chapter 893, Florida Statutes, and reckless driving in violation of Chapter 316, Florida Statutes; Mr. Harris pled nolo contendere to the charge of possession of cocaine, a felony, and was adjudicated guilty of the offense on or about February 21, 1990; and Mr. Harris was sentenced to probation for a period of one year. Although not listed in the letter informing Mr. Harris of the results of his background screening, Mr. Harris also was charged and pled nolo contendere to the offense of possession of cocaine with intent to sell in 1981 and driving under the influence of alcohol and possession of cannabis in 1995. The following are the only pertinent facts concerning the 1981 offense offered at hearing: On or about May 24, 1982, Mr. Harris pled nolo contendere to possession with intent to sell cocaine in violation of Chapter 893, Florida Statutes, a second degree felony, as a result of an incident that took place in 1981; and Mr. Harris was adjudicated guilty and was sentenced to probation for a period of eight years. The following are the pertinent facts concerning the 1995 offenses for driving under the influence of alcohol and possession of cannabis: Mr. Harris was driving an automobile in or near Bainbridge, Georgia, when he was stopped by law enforcement; Mr. Harris was charged with driving under the influence of alcohol and possession of cannabis that was found in the glove compartment of the automobile; Mr. Harris was adjudicated guilty of both offenses; and Mr. Harris was sentenced to probation for a period of one year and a number of week-ends in jail. At the time of the formal hearing Mr. Harris was 44 years of age. Mr. Harris' immediate supervisor, Rollean Lloyd (Ms. Lloyd indicated at the hearing that her first name is spelled "Rollean") testified at the formal hearing in support of Mr. Harris' continued employment at Florida State Hospital. Ms. Lloyd also signed a letter (Ms. Lloyd's first name is spelled "Rollene" on the letter) supporting his continued employment at Florida State Hospital. Ms. Lloyd's supervisor also testified at the formal hearing and signed a letter supporting his continued employment at Florida State Hospital: I have known John Harris for approximately eight years as an employee of Unit 4, Florida State Hospital. I have observed Mr. Harris over this time and he had become a concientious [sic] worker who relates well to the residents and to the staff in Unit 4. His recent attendance record has been good and Mr. Harris performs his job to the best of his ability. Mr. Harris is cooperative with his supervisors and supportive of his co-workers. For the past eleven years Mr. Harris has been, and was at the time of the formal hearing, married to Ollie Harris. Mr. Harris has two sons, one twenty years of age and the other eighteen years of age.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that a Final Order be entered by the Department of Children and Family Services denying John Harris' request for an exemption from disqualification from employment pursuant to Section 435, Florida Statutes. DONE AND ENTERED this 29th day of May, 1998, in Tallahassee, Leon County, Florida. LARRY J. SARTIN Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 Filed with the Clerk of the Division of Administrative Hearings this 29th day of May, 1998. COPIES FURNISHED: Ben R. Patterson, Esquire Patterson and Traynham 315 Beard Street Post Office Box 4289 Tallahassee, Florida 32315-4289 John Perry, Esquire District 2 Legal Office Department of Children and Family Services 2639 North Monroe Street Tallahassee, Florida 32399-2949 Gregory D. Venz, Agency Clerk Department of Children and Family Services Building 2, Room 204 1317 Winewood Boulevard Tallahassee, Florida 32399-0700 Richard A. Doran, General Counsel Department of Children and Family Services Building 2, Room 204 1317 Winewood Boulevard Tallahassee, Florida 32399-0700
Findings Of Fact On and after May 29, 1978, respondent Patricia Bose Haischer has been licensed by petitioner as a licensed practical nurse. She holds license No. 0482051. On May 1, 1981, an information was filed in the Circuit Court for the Sixth Judicial Circuit in Case No. CRC 8103052 CFANO (Pinellas County) charging respondent with "knowingly. . .commit[ting] a lewd and lascivious act in the presence of Yvonne Moir, a child under the age of fourteen years, by willfully and knowingly engaging in sexual activity in the presence of. . .Yvonne Moir. . .but without intent to commit sexual battery upon. . .Yvonne Moir." Petitioner's Exhibit No. 2. On her plea of guilty, respondent was adjudicated guilty of violating Section 800.04, Florida Statutes (1981), on August 19, 1981; and, on the same date, respondent was sentenced to twelve years' imprisonment. At the time of the hearing, respondent was confined at the Florida State Prison for Women. According to respondent's uncontroverted testimony, elicited in petitioner's case, she never fondled Yvonne Moir but was present and undressed while her husband had sexual intercourse with the child; she acted under the domination of her husband (who is now himself incarcerated for sex offenses) and was not altogether well emotionally at the time. Yvonne Moir was not in respondent's care as a nurse when these events transpired. Respondent's misbehavior evinced a disregard for Yvonne Moir's emotional health and reflects adversely on respondent's ability to practice nursing, for that reason. This opinion was expressed by a nurse with eighteen years' experience who testified for petitioner without objection from respondent. As a nurse, respondent has never harmed a patient or put a patient in jeopardy. She has had good recommendations from anybody who has ever supervised her, and one supervisor called her "trustworthy and dependable." During her imprisonment, respondent has visited a psychologist on a regular basis. She feels better and more confident about herself than she did at the time of the offense.
Recommendation Upon consideration of the foregoing, it is RECOMMENDED: That respondent suspend petitioner's license for two (2) years. DONE AND ENTERED this 20th day of April, 1982, in Tallahassee, Florida. ROBERT T. BENTON, II Hearing Officer Division of Administrative Hearings The Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32301 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 20th day of April, 1982. COPIES FURNISHED: Patricia B. Haischer Box 202 F.C.I. Lowell, Florida 32663 William R. Furlow, Esquire Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32301 Helen P. Keefe, Executive Director Board of Nursing 111 East Coastline Drive, Room 504 Jacksonville, Florida 32202 ================================================================= AGENCY FINAL ORDER ================================================================= STATE OF FLORIDA DEPARTMENT OF PROFESSIONAL REGULATION BOARD OF NURSING IN RE: PATRICIA MARIE B. HAISCHER, L.P.N. CASE NO. 0017303 License No. 0482051 DOAH NO. 81-3149 /
The Issue The issues presented by this case concern the question of whether the Respondent, State of Florida, Department of Health and Rehabilitative Services, has exhausted all treatment for the Petitioner, Gerald R. Straw, through sex offender programs administered by the Respondent. See Section 917.20, Florida Statutes.
Findings Of Fact The Petitioner submitted a "Petition for Administrative Determination" to the State of Florida, Department of Health and Rehabilitative Services. The Petition was received by the Division of Administrative Hearings on December 30, 1981, as transmitted by the State of Florida, Department of Health and Rehabilitative Services. The Department had requested the Division to conduct a formal hearing in keeping with Subsection 120.57(1), Florida Statutes. Final hearing in this cause was conducted on February 25, 1982. In the course of the final hearing, the Petitioner testified and offered as witnesses: Lois Turner, his mother; Alva Martin, R.N.; Larry Annis, Clinical Psychologist, and Kenneth Edwards, Vocational Education Instructor. The Respondent offered as witnesses: Robert Alcorn, Clinical Director for the Mentally Disordered Sex Offender Program at Florida State Hospital, and Larry Annis, Clinical Psychologist. The Respondent presented one (1) composite exhibit which was received into evidence. At all times pertinent to this proceeding, Petitioner has been in the custody of Respondent, in keeping with orders of court. His commitment has been on the basis of Chapter 917, Florida Statutes (1977), involving a breaking and entering criminal offense with related assault charges. In addition, the Petitioner has a past history in New York State for the criminal offense of sexual mischief. The arrest for the offenses in Florida occurred on July 22, 1977, and the Petitioner was committed to the Sexual Offender Program at North Florida Evaluation and Treatment Center on March 9, 1978. On August 3, 1978, a recommendation was made by staff of that facility to return the Petitioner to court for further disposition, based upon the belief that treatment had been exhausted. On September 13, 1978, he was released from that hospital program. That facility had not contacted other sex offender programs in the State of Florida prior to the release of the Petitioner and as a consequence, the Petitioner was recommitted to the Respondent by order of court dated October 31, 1978. He was placed in the sex offender program at Florida State Hospital in Chattahoochee, Florida, on January 27, 1979, and has resided in that program since that time. During his stay at Florida State Hospital, the Petitioner has undergone treatment in the program for the benefit of sex offenders. Although the Petitioner has been subjected to a full range of treatment opportunities, his progress in dealing with the underlying disorder which caused his placement has reached a juncture where improvement is no longer expected in the patient. In the face of these circumstances, the Respondent has made a preliminary determination that it has exhausted treatment for the Petitioner, through the program in which he is enrolled. Additionally, it has been concluded that similar programs within the State of Florida do not offer other opportunities for progress. These opinions were made known to the Petitioner and when confronted with this information, the Petitioner requested the formal hearing which is the subject of this Recommended Order. The program at Florida State Hospital has as its main focus the utilization of group therapy with adjunctive programs in recreation and occupational therapy, and this treatment regimen relies heavily on a patient's self-motivation. Respondent's Exhibit 1, admitted into evidence, is constituted of a series of clinical summaries related to the patient's performance during the course of his treatment at Florida State Hospital. In sum, the opinions stated in the clinical summaries accurately indicate that the Florida State Hospital has exhausted all available treatment for the Petitioner's underlying condition. Moreover, the presentation of the Petitioner's case to the Intra-Departmental Screening Committee, which is constituted of the administrative personnel of the various sex offender programs in the State of Florida, brought a correct perception that the Respondent has exhausted all available treatment for the Petitioner. Finally, the testimony given in the course of the hearing was in accord with those opinions expressed in the clinical summaries and the attitude of the Intra-Departmental Screening Committee. Petitioner's primary therapist, beginning in August, 1981, and continuing until the time of hearing, gave testimony in the course of the hearing. The therapist is Larry Annis, Clinical Psychologist. Annis shared the responsibility with a co-therapist until November, 1981, when he became the sole therapist for the Petitioner. Annis' testimony established that the Petitioner has been given a full and complete opportunity for participation in group therapy and in addition has been exposed to individual therapy sessions, and adjunctive therapy; to include, school, occupation and vocational training, ward government and participation in the ward milieu. The observed pattern of the Petitioner's participation in group therapy, on the part of Annis, is one of noting that the Petitioner talked to other persons in the group about their problems, but avoided talking about himself. In the group therapy sessions, Straw has denied having sexual problems and denied any guilt in connection with the underlying criminal offenses for which he stands convicted. (This was a similar attitude during the course of his stay at North Florida Evaluation and Treatment Center.) Annis indicated that the Petitioner has done well in adjunctive therapy, in particular, electrical wiring in which his performance has been exemplary. The Petitioner has not been found to be a management problem in terms of his conduct, according to Annis. The comments by Annis are correct. From Annis' observations, the Petitioner presents himself as attentative and having the ability to verbalize his feelings; however, his progress in the group therapy sessions has not been significant. In the therapy sessions, Annis has correctly identified that Straw is not interested in emotional discussions involving topics such as personal feelings, likes and dislikes, depression and anger. Petitioner is more interested in data collection and inquiring about why something is required, which is a more superficial concern. In the group sessions, Annis has found Petitioner to be truthful, if unwilling to explore personal areas such as those mentioned above, and in addition, sexual concerns. In the latter course of treatment, Annis has indicated that the matters of concern on the subject of the Petitioner's progress in the program relate to the Petitioner's ability to admit to negative feelings, anger and to explore antecedents to this type of emotion in order to arrive at alternative responses to he made to those emotions. Other specific concerns are as outlined in the fourteen (14) problem areas discussed in the August 13, 1981, clinical summary which is part of Respondent's Exhibit 1. Annis further indicated at the point where the determination was made that the treatment had been exhausted, that he, as therapist, has nonetheless continued to treat the Petitioner's condition and has undertaken a new method of dealing with the problem, to include the removal of bimonthly reports in trying to see how Petitioner would perform in a less structured environment. This technique has not been one leading to progress on the part of the Petitioner. In summary, Annis has correctly concluded that the Petitioner has reached maximum benefits from the program at Chattahoochee, and having exhausted available treatment, there would be no benefit to be derived by the Petitioner's continued participation in the program. The Unit Director at Florida State, Robert H. Alcorn, testified that the Petitioner's stay in the program was about average in terms of duration. Alcorn has observed no significant progress in the Petitioner in dealing with the underlying sexual problem. Alcorn finds the Petitioner to be socially isolated, and a person who refuses to discuss emotional matters and issues central to himself. Alcorn notes that the Petitioner deals in universal terms when dealing with the matters of daily life, to include other members of the sex offender program. Alcorn's observations are valid, and in the face of these observations, Alcorn presented the Petitioner's case to the Intra-Departmental Screening Committee and no further placement could be found for the Petitioner. In other words, it was correctly concluded that the Department, as well as Florida State Hospital had exhausted all appropriate treatment for the Petitioner. Petitioner's mother, Lois Turner, gave testimony. She has seen progress in the Petitioner's emotional demeanor and that opinion is borne out by observations of persons in the treatment program. In particular, HRS. Turner notes that her son does not now have periods in which his thinking seems to be disassociative. This is as contrasted with her observations of her son five (5) years ago when she found him to be very disoriented. HRS. Turner also observed that the Petitioner has been truthful with her in her discussions with him. Alva Martin, R.N. and therapist in the Sex Offender Program at Chattahoochee, indicated that she had treated the Petitioner from November, 1979, through May, 1980. During the course of her treatment, she observed that the Petitioner had improved in that he did not appear as withdrawn and became more involved in activities with other persons within the program. The goals in this entry level into the Sex Offender Program, which were set out by Martin for the benefit of the Petitioner, were to try to get Straw to converse more with other people about his problems and to have general conversations with individuals in the ward milieu. It was not the intention of this element of the therapy to question the Petitioner about the underlying charges for which he was placed in the program. Martin noted some progress on the part of the Petitioner in his dealing with his angry feelings and improvement in his ability to verbalize. Again, from her observations, the Petitioner was always truthful in his discussions. Kenneth Edwards, a Vocational Instructor at Florida State Hospital, first met the Petitioner in April of 1980. At that time, Edwards noted that the Petitioner lacked self-confidence and an ability to relate to others. Petitioner tended to stay by himself. There has been a dramatic improvement in this circumstance to the extent that the Petitioner now serves as an instructor for other program participants, in the field of television repair. Edwards feels that he has a good relationship with Straw and feels that Straw has improved in his relationship with other persons. Petitioner, in his testimony, indicated that he feels that he is not guilty of the offenses as charged. In addition, he feels that he has progressed while being treated in the program at Florida State Hospital, and although he feels that he still has an underlying problem with sexual acting out, he feels that he has completed the program successfully and could control any temptations of a sexual nature. He also feels that he has discussed his underlying sexual problems in the past and would be willing to in the future. He feels that he is being removed from the program because he refuses to admit that he is guilty of committing the offenses which caused him to be placed in the program. He also takes issue with the fourteen (14) problem areas set forth in the August 13, 1981, clinical summary. He thinks that any human being would have problems similar to that nature and that those are problems which are not unique to Gerald Straw. In summary, the Respondent has exhausted all appropriate treatment for the Petitioner's sexual deviance, but that treatment has not been totally successful and the patient continues to suffer with an underlying sexual disorder.
The Issue The issue is whether the medical license of Ted G. Avner, M.D., should be revoked or otherwise penalized based on the acts alleged in the Administrative Complaint.
Findings Of Fact At all times material to his action, Dr. Avner has been licensed in the State of Florida, holding license ME 0014896. Dr. Avner was licensed to practice medicine in Colorado in 1974. The Colorado State Board of Medical Examiners is the licensing authority for the State of Colorado. On December 9, 1985, the Colorado Board of Medical Examiners summarily suspended Dr. Avner's license to practice medicine due to substance abuse involving his personal ingestion of cocaine. On February 14, 1986, the Colorado Board of Medical Examiners, by Stipulation and Order, granted a reinstatement of Dr. Avner's license to practice medicine with certain terms of probation, including the prohibition of his use of substances of abuse. Subsequently, Dr. Avner relapsed by again using cocaine. After testing positive for cocaine on a random urine test, Dr. Avner reported that fact to the Colorado Board. On January 23, 1987, he entered into an agreement with the Colorado Board of Medical Examiners that he would refrain from the practice of medicine until permitted to do so by order of the board. Thereafter he entered and completed an addiction treatment program and then moved to Virginia, a state in which he was not licensed to practice medicine. Effective March 11, 1988, the Colorado State Board of Medical Examiners accepted Dr. Avner's voluntary relinquishment of his medical license. The Stipulation which Dr. Avner signed clearly states that the relinquishment was permanent, but it also provides for the reinstatement of Dr. Avner's license to practice medicine if he submits "evidence satisfactory to the Board that he qualifies under all subsections of the Colorado Medical Practice Act." The terms of the Stipulation and Order of the Board make it clear that the relinquishment was called "permanent," but was in fact subject to reinstatement. After moving to Virginia, Dr. Avner contacted David G. Fluharty, M.D. Dr. Fluharty is the founder and present Chairman of the Physicians' Health and Effectiveness Committee of the Medical Society of Virginia. The purpose and function of that Committee in Virginia is the same as that of the Florida Physician's Recovery Network administered by Roger Goetz, M.D. Dr. Fluharty referred Dr. Avner to the Talbott Recovery Center in Atlanta, Georgia. Dr. Avner completed the addiction treatment program there and returned to Virginia in March, 1989. Since March 29, 1989, Dr. Avner has continued to reside in Virginia, has remained active in the recovery program of the Physicians' Health and Effectiveness Committee of the Medical Society of Virginia, and has complied with all the requirements of that program, including random drug testing, maintaining sobriety, and participating in required meetings. Between March 29, 1989, and July 25, 1991, Dr. Avner's urine has been tested numerous times and all tests have been negative. Dr. Avner is currently under contract with the Physicians' Health and Effectiveness Committee of the Medical Society of Virginia which is very similar to and consistent with the kind of contract used by the Physician's Recovery Network in Florida for chemically dependent physicians. While residing in Virginia, Dr. Avner has worked regularly as a volunteer as a counselor and facilitator of the aftercare group, Caduceus. He also regularly attends other aftercare groups such as A.A. and N.A. Beginning in October, 1989, Dr. Avner worked once or twice a week as a volunteer at the Bradley Free Clinic, first as a nurse assistant and later assuming more responsibilities consistent with his licensure status. Dr. Avner has abstained from the use of cocaine since January 25, 1987, and from alcohol since August 19, 1989. He applied for a medical license in Virginia and was denied by Order dated April 11, 1988. In 1989, Dr. Avner applied for his medical license in Colorado and was initially denied. On his request for reconsideration, the Colorado Board granted licensure. By Order dated January 18, 1991, the Colorado Board of Medical Examiners approved a Stipulation and Order granting Dr. Avner an "unrestricted license" to practice medicine in Colorado, subject to the terms of probation set forth in the Order. On Dr. Avner's return to Colorado he can commence the practice of medicine under the terms and conditions of a monitored three-year probation which require that he maintain sobriety and abstain from all addictive, habit forming drugs or controlled substances not prescribed by his personal physician or dentist; that his practice and sobriety be monitored by a physician approved by the Board; that he and his monitor provide quarterly reports to the Board regarding the status of his practice and sobriety; that he participate in a Board approved drug abuse treatment program; that he provide urine tests on a random basis; and that he obtain and provide periodic psychological reports. Dr. Avner again applied for a medical license in Virginia and was denied by Order dated April 5, 1990. He again applied and was finally granted an unrestricted license by Order of the Virginia Board dated February 13, 1991. The Virginia license contains no term of probation or other restriction. In July, 1991, Dr. Avner began a one-year surgical fellowship in pediatric otolaryngology at the University of Virginia Medical School.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Department of Professional Regulation, Board of Medicine, enter a Final Order and therein: Reprimand Dr. Avner for violation of Section 458.331(1)(b). Restrict Dr. Avner's Florida license by requiring that Dr. Avner continue to remain in good standing in both Colorado and Virginia and that he comply with his contract in Virginia for its entire term. The Virginia Physicians' Health and Effectiveness Committee is to be asked to immediately notify the Florida Board of Medicine if Dr. Avner fails to remain in full compliance with that contract. Fine Dr. Avner in the amount of $1000.00. DONE and ENTERED this 8th day of October, 1991, in Tallahassee, Florida. DIANE K. KIESLING Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, FL 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 8th day of October, 1991. APPENDIX TO THE RECOMMENDED ORDER IN CASE NO. 89-5275 The following constitutes my specific rulings pursuant to Section 120.59(2), Florida Statutes, on the proposed findings of fact submitted by the parties in this case. Specific Rulings on Proposed Findings of Fact Submitted by Petitioner, Department of Professional Regulation, Board of Medicine Each of the following proposed findings of fact is adopted in substance as modified in the Recommended Order. The number in parentheses is the Finding of Fact which so adopts the proposed finding of fact: 1(1) and 3(3). Proposed finding of fact 2 is subordinate to the facts actually found in this Recommended Order. Specific Rulings on Proposed Findings of Fact Submitted by Respondent, Ted G. Avner, M.D. Each of the following proposed findings of fact is adopted in substance as modified in the Recommended Order. The number in parentheses is the Finding of Fact which so adopts the proposed finding of fact: 1-9(1-8); 10-15(10-15); 17-22(17- 21); and 23(22). Proposed finding of fact 24 is subordinate to the facts actually found in this Recommended Order Proposed finding of fact 16 is unsupported by the competent, substantial evidence. Dr. Falkinburg is not accepted as an expert qualified to render such an opinion, Dr. Fluharty's statements are hearsay and cannot support a finding of fact, and Dr. Goetz' testimony is entitled to little weight because it is based essentially on hearsay information. COPIES FURNISHED: Dorothy Faircloth, Executive Director Board of Medicine 1940 North Monroe Street Tallahassee, FL 32399-0750 Jack McRay General Counsel Department of Professional Regulation 1940 North Monroe Street Tallahassee, FL 32399-0792 Wilson Jerry Foster Attorney at Law 227 East Virginia Street Tallahassee, FL 32301-1263 Francesca Small Plendl Senior Attorney Department of Professional Regulation 1940 North Monroe Street Tallahassee, FL 32399-0792
The Issue The issues presented by this case concern the question of whether the Respondent, State of Florida, Department of Health and Rehabilitative Services, has exhausted all treatment for the Petitioner, Melvin Robinson, through sex offender programs administered by the Respondent. See Section 801.111, Florida Statutes (1975).
Findings Of Fact The Petitioner submitted a "Petition for Administrative Determination" to the State of Florida, Department of Health and Rehabilitative Services. The Petition was received by the Division of Administrative Hearings on November 4, 1981, as transmitted by the State of Florida, Department of Health and Rehabilitative Services. The Department had requested the Division to conduct a formal hearing in keeping with Subsection 120.57(1), Florida Statutes. The final hearing in this cause was conducted on January 5 1982, following a continuance of the previously scheduled hearing of December 16, 1981, which was designed to allow the Petitioner to gain the assistance of counsel. The Petitioner was unable to make those arrangements and the hearing was held with the Petitioner appearing pro se. In the course of the final hearing, the Petitioner testified and offered as witnesses, Alice Butler, Section Aide in the mentally disordered sex offender program, Florida State Hospital; Sterling George, Psychiatric Aide in the mentally disordered sex offender program at Florida State Hospital; and Alfred Gerardo, a participant in the sex offender program at Florida State Hospital. The Respondent offered as witnesses, Robert Alcorn, Clinical Director for the mentally disordered sex offender program at Florida State Hospital; Charles Shaffer, Clinical psychologist in the aforementioned program; Allison Dowling, Clinical social Worker in that program; and Lois Stevens, Clinal social Worker at Florida State Hospital. The Respondent presented two exhibits which were admitted into evidence. At all times pertinent to this proceeding Petitioner has been in the custody of Respondent, in keeping with orders of court. During that time, the Petitioner has resided at the Florida State Hospital, Chattahoochee, Florida, where he has undergone treatment in the program for the benefit of sex offenders, to include those persons committed under Chapter 801, Florida Statutes (1975), entitled "Child Molester Act." Although the Petitioner has been subjected to a full range of treatment opportunities his progress in the recognition of and the ability to deal with the underlying conditions which caused his placement in the program are at end. In the face of these circumstances, the Respondent has made a preliminary determination that it has exhausted treatment for the Petitioner, through the program in which he is enrolled. Additionally, it has been concluded that similar programs within the State of Florida do not offer other opportunities for progress. These opinions were made known to the Petitioner and when confronted with this information, the Petitioner requested the formal hearing which is the subject of this Recommended Order. Robinson was admitted to the forensic service at Florida State Hospital on October 9, 1990, to begin his participation in the mentally disordered sex offender program. He had previously been enrolled in the program from March, 1979, through February, 1979, a commitment under the terms of Chapter 801, Florida Statutes. Following his initial release from the program, Robinson was accused of violating the terms and conditions of probation and was adjudicated guilty of the offense for which probation was granted. Imposition of a sentence in that case was withheld and the Petitioner was returned to the custody of the Department of Health and Rehabilitative Services, in keeping with the rationale expressed in his original commitment to the program at Chattahoochee, which original commitment had occurred by Order of Court on February 20, 1976. In the matter of the most recent offense which had caused the revocation of Robinson's probation, Robinson received a sentence of ten years in the Florida State Prison; however, service of that sentence was stayed pending release and discharge from the custody of the Respondent on this most immediate commitment for care and treatment in the mentally disordered sex offender program. Beginning with the October 9, 1980, hospital stay, the goals of the program have been to deal with the patient's problems concerning sexual deviation, pedophilia; alcoholism; inadequate and passive aggressive personality styles and cultural deprivation. Notwithstanding the efforts of the patient and those of the staff to deal with the underlying disorders, this success has not been complete. The treatment has been exhausted in this program and other similar programs in the system in the State of Florida, and the Petitioner still presents a danger based upon his sexual deviation and propensity to commit sexual acts involving children, in particular minor females. These determinations are reached in the face of the facts that follow. The program at Florida State Hospital has as its main focus the utilization of group therapy with adjunctive programs in recreational and occupational therapy, and this treatment regime relies heavily on a patient's self-motivation. The Respondent's Exhibit 2 is a series of clinical summaries related to the patient's performance during the course of his treatment. The most recent evaluation points out, in general terms, the Petitioner's pattern of acting-out behavior and disregard for ward policy and, more importantly his lack of motivation and progress in the therapies which are essential to success in the program. In addition, testimony was given in the course of the hearing on the part of the Petitioner's therapist and other persons affiliated with the treatment team. Lois Stevens had been the Petitioner's primary therapist from October, 1980, to January, 1981. She observed in the Petitioner indications of low self- esteem; the fact that the Petitioner was easily disappointed; that he was easily influenced by others; that he had an inability to deal with abstract feedback and a problem of allowing himself to be abused. These were matters of concern which needed to be addressed as a prerequisite to dealing with the Petitioner's sexual deviation. In effect, this was a process of identifying the problems which underlie his sexual deviation. In this connection, Stevens found that the Petitioner had the desire to do better but evidenced poor judgment and impulse control. These circumstances were aggravated by the fact that the Petitioner had and has limited intellectual ability. During this phase no intense effort was made to discuss the sex offense, molestation of a young girl. While in this treatment situation, Robinson accepted staff criticism in an appropriate way and he did improve in personal hygiene, which had been a problem initially. After a period of time it was determined that the Petitioner should be placed with a separate therapist to go forward with his treatment. From January, 1981, to July, 1981, the Petitioner had Allison Dowling as his primary therapist. In the beginning Robinson performed reasonably well and had been given some freedom of movement within the facility and was granted a position as a patient volunteer on the ward. He was beginning to cope better in the institutional environment; however, he remained reluctant to examine, in therapy sessions, the problem of his sexual deviation. Specifically, that difficulty related to his ability to deal with insight oriented therapy. He would enter into a discussion of the offense in the therapy sessions, but tended to minimize the seriousness of his offense, demonstrating marginal understanding of the etiology and maintaining factors in his deviant sexual behavior. Moreover, between sessions with the group he tended to forget what had been dealt with on the prior occasion. He had to be prompted to participate, with one exception. As established by Dowling in this sequence of the treatment, the Petitioner began to act in an inappropriate way while on the ward and was tardy for group therapy sessions. In the connection with his misbehavior on the ward, it was necessary to force the Petitioner to engage in a discussion of those matters and the act of taking away his privileges of freedom of movement and position did not promote a change in the Petitioner. He attempted to manipulate staff members about the misbehavior and to have group members in the therapy sessions accept his side of the dispute as opposed to directly addressing problems. The items of misbehavior included homosexual activity with another participant of the program and sleeping in the nude, which were contrary to hospital policy. On another occasion the Petitioner attempted to get a staff aide to take him to an unauthorized activity, in violation of ward policy. Dowling has observed little progress in the Petitioner's attempts to control his sexual misbehavior and she correctly indicates that his sexual deviance still exists and no further progress can be made in dealing with this condition. Charles Shaffer, a clinical psychologist was the primary therapist for the Petitioner from November, 1981, to January, 1982. His observations concerning the progress of the Petitioner are in accord with those of Allison Dowling. He did note that the Petitioner has shown himself to be willing to help others with their daily problems but is unwilling to participate himself, and by way of explanation Robinson states that the other patients don't understand or can't understand his problem related to the sexual deviance. Shaffer's observations establish that the Petitioner is comfortable with his life style, and hasn't indicated any desire to change that pattern. Robert Alcorn, the director of the mentally disordered sex offender program at Florida State Hospital, through his testimony indicated agreement to the effect that the treatment had been exhausted in that program without success, which is an accurate depiction. Alcorn also established that conferences related to Robinson's potential placement in affiliated sex offender programs led to the conclusion that those programs could not assist the Petitioner, ergo, treatment has been exhausted in those other facilities. The Petitioner, through his testimony, acknowledged that he had participated in homosexual activities at the hospital and had been punished by the suspension of his grounds privileges and job opportunity. Following those episodes the Petitioner indicated that he lost interest in participating in the program but did in fact participate. He acknowledged that he attended occupational therapy, as well as the primary therapy, and was tardy at times. Robinson admits that he has difficulty explaining himself and has problems with impulse control. He says he can't find himself, is tired of being a nothing. Robinson believes he does not always think before acting. Finally, he has a fear of returning to court and facing the disposition of his case. Alice Butler, a witness for the Petitioner who was a co-therapist at the time that Stevens was assigned to Robinson's case, established that earlier in the treatment Petitioner was more motivated in his participation than he has been recently. And, in fact, the Petitioner has broken the rules as recently as two weeks prior to the hearing by sleeping nude. She also observed that the Petitioner has been in the so-called "observation section" for a long time and is satisfied with his placement. (This particular section is a more restricted area than some of the other advanced wards.) Sterling George, a psychiatric aide and witness for the Petitioner from his observation finds that as a general proposition the Petitioner takes part in activities with other patients and is not a problem on the ward. Finally, Alfred Gerardo, another participant in the mentally disordered sex offender program, gave testimony. He has known the Petitioner for approximately fifteen months. He has also participated in the same group with Robinson from October, 1980, through May, 1981. His initial impressions of Robinson were not favorable, but in the last few months he has gained a better appreciation of the Petitioner. In particular, he has observed Robinson to have made improvement in terms of his willingness to he concerned about matters of education and acting-out, and in the realm of the Petitioner's appearance. From this witness's understanding the Petitioner's participation in group activity is limited and particularly so in the area of the underlying sexual problem. In summary the Respondent has exhausted all appropriate treatment for the Petitioner's sexual deviance, but that treatment has not been totally successful and the patient continues to be a sexual menace, and there is a likelihood that the Petitioner would commit other sexual crimes.
