The week before he was killed by a brick-wielding, 400-pound mental patient, Terry Young told his mother not to worry.
It was a Saturday in late April 2013. Bettye White, a retired elementary-school principal, had made her weekly trip to see to her 53-year-old son at the Liberty City Hope Center, a three-story, shabby building stacked around a central courtyard off NW 13th Avenue in Miami. Young was sitting out front on some logs, a cigarette hanging from his mouth, wearing a crayon-blue basketball jersey and jeans. His dark hair, dusted slightly with gray, seemed unruly.
Young was in good spirits, his mom remembers. White brought along her great-granddaughter Brooke, and Young played merrily with the 4-year-old. After 30 minutes, great-grandmother and little one prepared to leave. White promised to deliver homemade banana pudding next time. As she began to voice the myriad concerns swimming through her head, he interrupted.
"Time to take off the mama hat," he said.
It was hard not to worry about Young. For years, he'd struggled with mental problems which started after a series of beatings he'd taken during a fraternity initiation in 1978. Medication and assisted living had stabilized him as an adult. But now, a string of recent bad breaks had landed Young at this crumbling Liberty City facility run by a convicted felon-cum-hustling preacher named Vincent Spann. White's gut told her Young wasn't getting the help and supervision he needed.
A week later, while she prepared Young's pudding in her Pembroke Pines kitchen, the phone rang. On the other end was Spann.
Young had been murdered by his roommate.
While "tied down by their arms and legs, chemical sedatives are routinely administered."
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That bloody death is part of a pattern of patient problems that track back to Citrus Health Network, a Hialeah-based nonprofit that receives millions in government funding annually to provide a safety net for low-income patients fighting health and mental problems. Since 2004, the organization has been directly or indirectly implicated in everything from sexual assault at a foster home to dozens of reports of abusive practices at a Pembroke Pines facility for troubled teens.
This past April, Young's family sued Citrus Health Network, along with the U.S. Department of Health and Human Services, claiming the firm "had negligently placed [him] in a dangerous, unlicensed facility/accommodation run by, and inhabited by, dangerous felons."
"Terry and his family relied on Citrus to provide Terry with appropriate mental-health care and with trained and qualified mental-health providers," says Richard Sharp, White's attorney. "Instead, Citrus placed Terry in an unlicensed facility, operated by untrained, unqualified individual.Mental-health patients without their medications, placed in an unsupervised setting, is a recipe for disaster."
Citrus President and CEO Mario Jardon did not reply to a detailed list of questions regarding Citrus' role in past cases of abuse. In response to queries on Young's case, he would say only: "We served him for years, including brand-new apartments where he peacefully resided." The state Department of Children and Families, which oversees an oft-cited center for juveniles in Pembroke Pines run by Citrus, reviewed past complaints and concluded: "The issues and deficiencies identified were addressed, and action was taken," according to a spokesperson.
Citrus Health Network is a power player in the world of South Florida low-income medicine. It was founded in 1978 to provide medical treatment for uninsured pockets of South Florida's poor. After years of growth, the organization today is one of only six health centers in Miami-Dade County that qualify for enhanced reimbursements from Medicare and Medicaid. Today, the organization has a $61 million yearly budget and serves 10,000 patients annually at various locations and through numerous programs, from preventive care and health screening to housing services.
Despite its mandate to provide health care for the most vulnerable cross section of society — poor and sick — the organization has been dogged by claims of negligence.
In April 2006, Citrus took over the license of a Miami foster home housing two troubled kids, a 6-year-old girl and a 14-year-old boy, according to a lawsuit. The girl, the victim of past sexual abuse, had a well-documented history of aggressive sexual behavior toward men. The teenaged boy had been accused a year before of forcing another, handicapped foster sister to perform oral sex. Sexual abuse started between the two — oral, vaginal, and anal sex.
Although in September 2006 the girl told a psychologist about the abuse, Citrus kept the two together in the foster home until April 2007, when the foster mother discovered the behavior.
In 2011, the girl's mother sued Citrus, as well as other parties involved, for negligence. Citrus responded in court by denying the claims.
The mother's attorney, Stuart Mermelstein, tells New Times the case against the organization was "resolved." He declined to say whether it involved a financial settlement.
In August 2013, an attorney with the Broward Public Defender's Office sent a letter to the Florida Department of Children and Families regarding the treatment of patients at a Citrus-run facility for mentally ill teenagers in Pembroke Pines. The 56-bed operation routinely placed teenagers "in isolation for prolonged periods of time using a four-point physical restraint technique," the attorney wrote; patients were "tied face-down to a bed for minor infractions," and while "tied down by their arms and legs, chemical sedatives are routinely administered."
An internal investigation substantiating the complaints by South Florida Behavioral Health Network, a nonprofit that placed patients in the Citrus facility, concluded that "patterns have been developed by individual staff as well as the program at large that are not conducive to the population served." The use of chemical and physical restraints had risen dramatically each year, according to the report.
A subsequent New Times 2014 investigation found 11 instances in which the facility had been cited for infractions by the Florida Agency of Health Care Administration and the Department of Children and Families. The violations ran from pregnant teenagers not receiving extra food at mealtimes to instances in which Citrus staffers administered high-powered medications without prior consent from teens' legal guardians, as required by law.
The report and investigation pointed to a troubling trend: Citrus was allowing harm to the very people it was entrusted (and paid) to help. If the allegations in the lawsuit filed by Young's family are true, his case seems to lead to the same conclusion.
Born in Georgia and raised in Carol City, Young was a sports-obsessed high school running back whose dreams of college gridiron action were wrecked by a broken ankle. Despite the disappointment, when Young headed off to the University of Florida in 1979, he fixed on a new goal: pledging the Omega Psi Phi fraternity.
In Gainesville, the all-black organization was known for its brutal rush; upperclassmen administered nightly beatings. Despite the abuse, Young kept at it. His parents had recently divorced. He'd recently broken up with a girlfriend. His imploded football career still chewed at him.
The frat became a life raft for the 19-year-old.
In December, after the rest of his pledge class dropped out due to the abuse, Young lost his mental moorings. One day, be began running around campus claiming he had become an Omega man and that now he'd be able to get his parents back together, reunite with his ex, even get a fired UF football coach his job back. Bettye White rushed to campus and later had him evaluated at a Miami hospital.
"Even when I was in the hospital in Miami, I thought it was part of the pledge thing," Young told Tropic magazine in a 1979 article on the hazing. "I thought the hospital was just the final part of the initiation."
Doctors diagnosed Young with extreme depressive reaction, symptoms that later were linked to bipolar disorder. Young tried going back to school, but he would be overcome by waves of agitation, his mother says. It would take almost ten years for Young to level out. But by 1988, he was living in an assisted-living facility and functioning on a daily dose of Mellaril, a sedative. Starting in 1991, his care was managed by Citrus.
After that, Young lived a close-to-normal life, his mother says. He would go with the family on vacations, come over every weekend for dinner and holidays, and babysit his niece and grandniece.
Everything changed in 2013. Young's longtime case manager at Citrus left at the end of the previous year. The nonprofit, White says, didn't assign her son a new permanent case manager. Then Young's leg was broken when he was hit by a car, and he was forced to move out of Buena Vista Villas, an assisted-living center managed by Citrus where he had been staying. That's when Citrus suggested placing Young in the Liberty City Hope Center.
"Citrus told [White] that... he's going to be fed there," says Sharp, the attorney for Young's family. "He's going to be supervised; he's going to get medicine administration."
But almost as soon as Young moved in February 5, he stopped receiving his medication, his mom says. He complained there was no one to cook the meals. There was no staff-enforced curfew. Young began wandering around the crime-saddled neighborhood. He argued verbally with his roommates and staff, who White contends were mainly felons.
But whenever White complained to Citrus about the facility, she didn't get an answer.
On April 28, a little more than a month into Young's stay at the Liberty City place, he was beaten to death with a brick by his roommate, a scale-topping 400-pound hulk named Niki Williams who'd been charged with grand theft a year before. (That was later dropped.) The two men had been involved in an ongoing argument since the previous Friday. About what remains unclear, but no one at Liberty City intervened or separated the men. Young's body was found behind the building. Williams was arrested for second-degree murder, although he was later found to be incompetent to stand trial.
Though she has sued both Citrus and the federal government, White blames the Hialeah nonprofit for her son's death. Instead of providing her mentally ill son with the support he needed, Citrus shunted him off to the worst possible facility for someone in his condition, she feels.
"It was patient dumping, as far as I can see," she says. "They wanted to get rid of Terry."
