HB 443

1	A bill to be entitled
2	An act for the relief of Marissa Amora; providing an
3	appropriation to compensate Marissa Amora, a minor, by and
4	through her legal guardians, Dawn Amora and Ricardo Amora,
5	for injuries she sustained as a result of the negligence
6	of employees of the Department of Children and Family
7	Services; providing for payment into a restricted
8	guardianship account; providing for payment of costs;
9	providing for repayment of Medicaid liens; providing a
10	limitation on attorney's fees, lobbying fees, costs, and
11	other similar expenses relating to the claim; providing an
12	effective date.
13
14	WHEREAS, on November 8, 2000, Moesha Sylencieux, now known
15	as Marissa Amora, who was not yet 2 years old, was brought to
16	the emergency room of Bethesda Memorial Hospital in Palm Beach
17	County, Florida, and
18	WHEREAS, Marissa Amora's natural mother told the hospital
19	staff that Marissa Amora fell from a standing position and
20	consequently could not walk, and
21	WHEREAS, while she was at the hospital, Marissa Amora could
22	not bear weight on her legs, and
23	WHEREAS, during a 3-day admission that followed, an MRI
24	showed the presence of an unexplained mass in the area of
25	Marissa Amora's spine, and she was transferred to Miami
26	Children's Hospital for further testing and treatment, and
27	WHEREAS, Marissa Amora was admitted to Miami Children's
28	Hospital on November 11, 2000, arriving with a working diagnosis
29	of "spinal cord tumor," and during the following month she was
30	fully evaluated for the tumor that was presumed to have
31	accounted for her sudden inability to walk, with all test
32	results normal, and
33	WHEREAS, on December 4, 2000, Marissa Amora underwent a
34	biopsy of the mass in the area of her spine, which indicated
35	that the mass was benign, and
36	WHEREAS, during Marissa Amora's approximately 1-month
37	admission to Miami Children's Hospital, several incidents gave
38	rise to suspicions and concerns on the part of the hospital
39	nursing staff and social workers with respect to Marissa Amora's
40	safety, and
41	WHEREAS, the hospital staff and social workers were
42	concerned about the natural mother's lack of involvement with
43	her daughter and about the interactions between Marissa Amora
44	and her natural mother who, over the course of Marissa Amora's
45	hospitalization at Miami Children's Hospital, came to the
46	hospital only four times, and who failed to visit her at other
47	times during her hospitalization even though hospital social
48	workers provided her with directions and money for
49	transportation, and
50	WHEREAS, when Marissa Amora's natural mother did come to
51	the hospital, families of other patients observed her spanking
52	Marissa Amora while Marissa was in her hospital bed, and
53	WHEREAS, Marissa Amora's natural mother failed to come to
54	the hospital on December 9, 2000, the day that her daughter was
55	supposed to be discharged, and
56	WHEREAS, with Marissa Amora waiting to be discharged, the
57	social workers at the hospital appropriately called the
58	Department of Children and Family Services, the call being
59	designated as one for "special needs," given the mother's lack
60	of ability or desire to care for her daughter and the general
61	lack of bonding between mother and child, and
62	WHEREAS, Marissa Amora's case was assigned to a protective
63	investigator for the Department of Children and Family Services
64	in District 11, Miami-Dade County, Shirley Arias, who commenced
65	her investigation by going to Miami Children's Hospital on
66	Monday, December 11, 2000, at which point she began compiling a
67	list of concerns and risk factors that indicated possible
68	physical abuse, and
69	WHEREAS, Investigator Arias reviewed the hospital records
70	and found that there was evidence that Marissa Amora had an
71	unexplained fracture of her clavicle and that, though the mother
72	had been assisted and counseled by the social workers at the
73	hospital, the social workers continued to have serious concerns
74	for the mother's desire and ability to care for her child, and
75	WHEREAS, Investigator Arias observed that Marissa Amora
76	would cry when her mother walked into her hospital room and then
77	would become calm when her mother would leave, and also observed
78	a general lack of bonding between mother and child, and
79	WHEREAS, on Monday, December 11, 2000, a meeting took place
80	in the hospital between Investigator Arias, Marissa Amora's
81	natural mother, and Dr. Jefry Biehler, an in-house director of
82	the Child Advocacy Team who was asked to be involved at the
83	request of the hospital's social workers, and
84	WHEREAS, Dr. Biehler interviewed the natural mother in the
85	presence of Investigator Arias and reported that he "had
86	concerns" and recommended to Investigator Arias that the child
87	should not be given to the mother unless a home study was
88	completed to ensure that the environment in the home was safe
89	for the child, and
90	WHEREAS, the suggested home study was never performed by
91	the department, and
92	WHEREAS, instead of initiating a home study, Investigator
93	Arias contacted the department's Palm Beach County District 9
94	office, whereupon the matter was referred to Protective
95	Investigator Evelyn Diaz Collins, and
96	WHEREAS, Investigator Collins failed to conduct or initiate
97	a home study, and
98	WHEREAS, Investigator Collins instead went to the family
99	home while Marissa Amora was still in the hospital, met with the
100	natural mother, noting that the apartment was devoid of any baby
101	items, and subsequently informed the natural mother that she
102	would need to purchase a crib and that she would return the
103	following week to make sure that this condition had been
104	complied with, and
105	WHEREAS, Investigator Collins never returned to the home
106	and performed no followup whatsoever, and
107	WHEREAS, the requested home study was never completed, yet
108	department supervisors in Miami incorrectly believed that a home
109	study had been completed, and incorrectly assumed that there was
110	no threat to the child, and
111	WHEREAS, Investigator Arias met with her supervisor, who
112	advised that she should refer the case to the Department of
113	Children and Family Services' legal department, whereupon
114	investigator Arias consulted with the legal department on
115	Wednesday, December 13, 2000, and was advised that Marissa Amora
116	should not be allowed to leave Miami Children's Hospital until
117	the department had completed a home study, spoken with Marissa
118	Amora's natural father in New Jersey, assigned staff to the case
119	from the child protection team, and conducted criminal checks of
120	the appropriate parties, and
121	WHEREAS, deposition and trial testimony by Investigator
122	Arias revealed that she understood that the required home study,
123	the contact with Marissa Amora's natural father, the assignment
124	of staff to the case from the child protection team, and the
125	conduct of specified criminal checks were departmental "marching
126	orders" and that Marissa Amora should not have been allowed to
127	leave the hospital until all of these conditions had been
128	complied with, and
129	WHEREAS, on December 14, 2000, Investigator Arias completed
130	a departmental initial child safety assessment form, as required
131	by statute, which showed that Investigator Arias and her
132	supervisor concluded that physical abuse of Marissa Amora was
133	suspected, and
134	WHEREAS, Investigator Arias testified at trial that Marissa
135	Amora should never have been allowed to go home, that sending
136	Marissa Amora home was wrong, and that she should have voiced
137	her objection to her supervisors, and
138	WHEREAS, Investigator Arias' immediate supervisor, Robert
139	Boyak, testified under oath that the case should have been
140	assigned to the child protection team before Marissa Amora was
141	allowed to leave the hospital, but that no such referral to the
142	child protection team was completed, and
143	WHEREAS, on December 14, 2000, Investigator Arias began
144	contacting Marissa Amora's natural mother for the purpose of
145	having Marissa Amora picked up from the hospital, despite the
146	fact that a home study had not been completed, the case had not
147	been assigned to the child protection team, and Marissa Amora's
148	natural father had not been consulted, all of which had been
149	advisements of the Department of Children and Family Services'
150	legal department on December 13, 2000, and
151	WHEREAS, the department's log written by Investigator Arias
152	reflects numerous contacts prior to discharge from the hospital
153	from the social workers at Miami Children's Hospital challenging
154	the department's decision to allow Marissa Amora to go home with
155	her natural mother, and
156	WHEREAS, calls placed by the hospital's social workers to
157	the department's Palm Beach County district office, to the
158	Miami-Dade district office, and to supervisors in the chain of
159	command at the department were either not returned or, when
160	calls were returned to social workers, they were given false
161	assurances that the department's investigation had revealed that
162	there was no danger to Marissa Amora, and
163	WHEREAS, on December 15, 2000, Marissa Amora cried while
164	she was being taken from Miami Children's Hospital by her
165	natural mother, and the department was repeatedly told that
166	hospital social workers were very dissatisfied with the decision
167	to allow the child to go home with her natural mother and that
168	hospital nurses were willing to adopt Marissa Amora, and
169	WHEREAS, on January 11, 2001, Marissa Amora was again
170	admitted to the hospital's pediatric intensive care unit for
171	treatment for massive brain injuries, leg fractures, arm
172	fractures, and multiple other injuries that the chief of
173	pediatric intensive care opined were likely due to being swung
174	by her arms and legs and smashed into a wall or the floor, and
175	WHEREAS, the child protection team in Palm Beach County, as
176	well as hospital physicians in Boca Raton and Delray Beach,
177	determined that Marissa Amora's problems, dating back to the
178	admission to Bethesda Memorial Hospital on November 8, 2000, and
179	the life-threatening trauma with severe brain damage sustained
180	on January 11, 2001, were due to injuries caused by physical
181	abuse, and
182	WHEREAS, Marissa Amora remained in the hospital for several
183	months while undergoing a series of operations, including brain
184	surgery to relieve pressure from massive bleeding in her brain,
185	a tracheotomy to establish and maintain her ability to breathe,
186	and abdominal surgery to allow for nutrition to pass directly
187	into her stomach due to an inability to eat, and
188	WHEREAS, Marissa Amora has since required subsequent
189	additional surgical procedures to address many of the chronic
190	problems caused by her severe brain injury, and continues to
191	require tube feedings because she is unable to eat food by
192	mouth, and
193	WHEREAS, Marissa Amora will require a high level of care
194	throughout the remainder of her life, and
195	WHEREAS, employees of the Miami-Dade County and Palm Beach
196	County offices of the Department of Children and Family Services
197	admitted to making critical errors with regard to this case and
198	admitted that department procedures were not followed, and
199	WHEREAS, as a result of the negligence of the employees of
200	the Department of Children and Family Services, Marissa Amora
201	has suffered permanent and profound brain damage and will
202	require total care for the remainder of her life, and
203	WHEREAS, at trial the jury determined Marissa Amora's total
204	past and future economic losses to be $21,070,000, and her past
205	and future noneconomic damages, which include disability, loss
206	of enjoyment of life, bodily injury, physical and mental pain
207	and suffering, and disfigurement, to be $13,750,000, and
208	WHEREAS, the life care plan for Marissa Amora, as devised
209	by former District 11 Administrator and Certified Life Care
210	Planner for the former Department of Health and Rehabilitative
211	Services of the State of Florida, Lawrence Forman, M.Ed., has a
212	present value cost of $23,116,052.50, and
213	WHEREAS, the department's own experts, Sharon Griffin,
214	M.Ed., Habilitationist, and Bernard F. Pettingill, Jr., Ph.D.,
215	Economist, developed a life care plan for Marissa Amora, at an
216	estimated cost of $19,767,867, some of which the state contended
217	could be borne by Medicaid or Med-waiver, and
218	WHEREAS, Marissa Amora's past medical care and expenses,
219	including liens, amount to $458,719.89, and
220	WHEREAS, in legislative hearings on the claim it was the
221	finding of the Special Master that a restricted guardianship be
222	established for Marissa Amora, through which all funds
223	appropriated for the relief of Marissa Amora would be
224	administered, NOW, THEREFORE,
225
226	Be It Enacted by the Legislature of the State of Florida:
227
228	Section 1.  The facts stated in the preamble to this act
229	are found and declared to be true.
230	Section 2.  (1)(a)  The sum of $26,849,849.08 is
231	appropriated from the Administrative Trust Fund of the
232	Department of Children and Family Services, or any successor
233	thereto, or, in the event sufficient funds are not available
234	from that fund, from the General Revenue Fund, to be paid to
235	Marissa Amora, a minor, by and through her parents and legal
236	guardians, Dawn Amora and Ricardo Amora, to finance the
237	habilitative care of Marissa Amora over the duration of her
238	lifetime, as relief for the violations of her rights, and for
239	injuries and damages she sustained as a result of the wrongful
240	or negligent conduct of the Department of Children and Family
241	Services.
242	(b)  The sum of $102,837 is appropriated from the
243	Administrative Trust Fund of the Department of Children and
244	Family Services, or any successor thereto, or, in the event
245	sufficient funds are not available from that fund, from the
246	General Revenue Fund, to be paid to the claimant's attorneys as
247	reimbursement for costs.
248	(2)  The governmental entity responsible for payment of the
249	warrant shall pay to the Agency for Health Care Administration
250	the amount due under section 409.910, Florida Statutes, prior to
251	disbursing any funds to the claimant. The amount due the agency
252	shall be equal to all unreimbursed medical payments paid by
253	Medicaid up to the date upon which this bill becomes a law.
254	(3)  Any amount awarded under this act pursuant to the
255	waiver of sovereign immunity permitted under s. 768.28, Florida
256	Statutes, and this award is intended to provide the sole
257	compensation for all present and future claims arising out of
258	the factual situation described in the preamble to this act
259	which resulted in the injury to Marissa Amora. The total amount
260	paid for attorney's fees, lobbying fees, costs, and other
261	similar expenses relating to this claim may not exceed 25
262	percent of the amount awarded under subsection (1)(a).
263	Section 3.  The Chief Financial Officer is directed to
264	execute all necessary agreements to implement the payment of
265	this claim, and to draw a warrant in the amount of
266	$26,952,686.08 in favor of Marissa Amora, by and through her
267	parents and legal guardians, Dawn Amora and Ricardo Amora, upon
268	funds of the Department of Children and Family Services in the
269	State Treasury, and the Chief Financial Officer is directed to
270	pay the same out of such funds in the State Treasury. After
271	payment of Medicaid liens as provided in section 2(2), payment
272	of $102,837 in costs as provided in section 2(1)(b), and payment
273	of fees as limited by section 2(3), the remainder shall be
274	deposited into the restricted guardianship account established
275	for the exclusive use and benefit of Marissa Amora.
276	Section 4.  This act shall take effect upon becoming a law.

CODING: Words stricken are deletions; words underlined are additions.