The challenges and threats of court-appointed guardianships and conservatorships are often portrayed as impacting predominantly older people with impaired or declining cognitive capacity. The harsh reality is that when a system is broken, victims come from a wide spectrum of not-so- easily classified people. In planning, the worst case scenario is that a healthy person is wrongly alleged to be incompetent or incapacitated, and there are plenty of examples of that situation occurring. Beyond, the worse case, however are folks who suffer a myriad of actual, alleged, and yes, even feigned, impairments, disabilities, and illnesses.
Among the most troubling recent cases, reported by Voice of San Diego, is that of Maria Moore, who has spent almost five years in a San Diego County jail without having been convicted of a crime. It describes the drawn-out case as underscoring the "complexity of prosecuting someone who’s severely mentally ill, pitting criminal justice, psychiatry and conservatorships against one another." Moore’s situation also speaks to a "shortage of psychiatric beds in California," in a legal and health care system with limited and already overly-taxed resources:
More than a decade ago, the district attorney’s office charged the 81-year-old in the beating death of another elderly woman in South Bay. Moore is one of the longest-serving prisoners in San Diego County who’s yet to go on trial. And she might never.
Moore’s case attracted media attention at the time, with headlines describing her as the victim's caretaker. That turned out to be untrue. A prosecutor later told the Superior Court that the victim, Charmian Antaramian, had met Moore a few months prior and allowed her to move in. Court records suggest that Moore had once scalded Antaramian with hot water, sold herself as the trustee of the victim’s estate and isolated her from friends.
After a concerned relative requested a welfare check, an SDPD officer crawled through a window in the house, located in the Palm City neighborhood, and found Antaramian’s body, the Star News reported. A prosecutor said police arrested Moore at a neighbor’s house while she was in the process of purchasing a Greyhound bus ticket. Moore later claimed to be a lay nun.
It was a sensational case. But its drawn-out history underscores the complexity of prosecuting someone who’s severely mentally ill, pitting criminal justice, psychiatry and conservatorships against one another. Moore’s situation also speaks to a shortage of psychiatric beds in California.
The criminal proceedings were immediately suspended so that the Superior Court could determine whether Moore was fit to stand trial. Judges waffled on this question for years, as attorneys dug up new information and medical professionals offered one opinion after another. Moore was removed from the courtroom for her outbursts on several occasions.
In 2011, a judge concluded that Moore was mentally incompetent, then changed his mind a few months later. By the following year, he was back to his original position. In 2014, a different judge came to a different conclusion and set a new arraignment date, allowing criminal proceedings to resume. Those efforts were short-lived, though.
The issue of mental competency was put to rest in 2015, when a third judge determined, at least for the time being, that Moore was unfit to participate in her criminal defense.
To keep the murder case alive, prosecutors had relied on the testimony of a psychiatrist who said Moore was “malingering with the objective of avoiding criminal prosecution.” The psychiatrist found it “extremely unlikely,” he said, that Moore has a delusional disorder because the onset is usually 40 years of age, but she had no recorded history of psychiatric problems until her arrest.
Public defenders, however, produced mental health and criminal records from New Mexico showing that Moore had been diagnosed much earlier in life as a paranoid schizophrenic. She’d also been evaluated in the late 1980s as a result of criminal proceedings at the time.
Following her arrest in 2010, Moore was mostly confined to a state psychiatric hospital in Patton, Calif., outside San Bernardino. But in 2016, after being declared unfit for trial once again, Moore was booked in jail.
For nearly the last five years, she’s lived at the Las Colinas Detention and Re-entry Facility in Santee, the primary point of intake for women prisoners in San Diego County, which is home to a psychiatric security unit.
The facility has a better reputation these days — the Washington Post Magazine called it “a gold standard for gender responsive-corrections” in 2019 — but it wasn’t always that way. The San Diego County Grand Jury visited Las Colinas in 2006 and expressed surprise at the appalling conditions — “the floor of at least one dorm was caving in,” the group wrote. A new version of the facility opened in 2014 under design principles intended to reduce “physical and psychological barriers and promote direct and constructive communication among staff and inmates,” according to one architectural firm.
Moore is not eligible for release. It’s still possible she could one day go on trial, but only under a limited set of circumstances.
After the murder case against her stalled, the county became legally responsible for Moore’s well-being. The court agreed to place her in the care of the public conservator under what’s known as an LPS conservatorship, a civil program for Californians who suffer from biological brain disorders. It’s meant to protect gravely disabled people from civil rights abuses while at the same time involuntarily committing them to treatment.
At the request of prosecutors, Moore was later placed into what’s known as a Murphy conservatorship, which is set aside for people facing an outstanding felony charge. It’s a different legal standard than, say, being found not guilty by reason of insanity and has the goal of restoring one’s mental competency.
The conservatorship undergoes regular reviews, which is why Moore appears in the sheriff’s inmate database for “mental comp” and not murder. If there is a change in her status, that could trigger a new round of criminal hearings. The idea, in other words, is to get her well enough so she can participate in her own defense.
“If the defendant becomes mentally competent after a Murphy conservatorship has been established, the conservator must certify that fact to the sheriff and the district attorney, the defendant’s attorney and the committing court,” wrote DA spokesperson Steve Walker in an email.
In the meantime, the Sheriff’s Department confirmed that Moore is waiting for an available bed at a state hospital but couldn’t immediately say for how long. “I’m sure COVID delayed the hospitals being able to receive new clients/inmates,” Lt. Amber Baggs, a department spokesperson, wrote in an email.
A state audit in 2020 took issue with how Californians with serious mental illnesses are cared for. It noted that people in conservatorships have limited treatment options because the wait time to get into a state hospital can take a year on average.
“California does have an extreme shortage of beds,” said Lisa Dailey, acting executive director of the Treatment Advocacy Center, a nonprofit based in Virginia, “and a lot of that is because something like 95 percent of beds are taken up with forensic patients, people who are facing charges or otherwise in the criminal justice system.”
Still, the amount of time Moore has spent in jail as opposed to a state hospital seems extreme, Dailey said. “I’ve never heard of a case lasting five years.”
There are a number of outstanding questions in Moore’s case, like whether her legal representatives have tried to get her into a state psychiatric hospital and for how long they’ve been pushing. It’s hard to tell from the outside, because the records from Moore’s mental health hearings are not publicly available. One of the San Diego County deputy public defenders who represented Moore and the Public Conservator’s Office did not respond to requests for comment.
Moore’s case may be an extreme one, but she’s not necessarily alone.
CalMatters recently found that 44,241 people languishing in a county jail across the state — three quarters of all inmates — haven’t been convicted of, or sentenced for, a crime. San Diego County was home to more than 2,300 such people, including, KPBS reported, 380 who’ve been in jail for more than a year and 20 who’ve been in jail for three years and counting.
As you read this story, it easy to distinguish Ms. Moore's plight as so completely different from your own, that there is no useful information it can provide. That distinction is correct, perhaps, but correctly analyzed should be troubling. Ms. Moore is accused of a crime, and she has a myriad of federal and state constitutional protections, designed to ensure that no one accused of a crime is permanently incarcerated without recourse or proof. Yet, there she is, armed with a state appointed counsel, and a basket-full of protections, wasting in a jail cell.
A senior alleged to be incompetent or incapacitated is not an accused criminal, and is not afforded the same basket of constitutional protections. A senior accused of a health or cognitive impairment is not accused of a crime, and is therefore more vulnerable, less protected, and often without legal counsel. Substitute a nursing home for a jail cell, and a medical condition for a criminal charge, and Ms. Moore's plight might be more obviously similar, but her plight should nonetheless speak to everyone.
Thanks to the National Association to Stop Guardian Abuse for highlighting the article on its blog.
