Nursing home setting agreed for rest of Howell's sentence

Calling the medical condition of a former Roachdale physician a "much greater life sentence than any sentence a court can issue," Putnam Circuit Court Judge Matt Headley has ordered him to spend the remainder of his prison time in a nursing home setting.

The 58-year-old Ray D. Howell, who in June 2012 pled guilty to five felony counts of unlawfully dispensing narcotics to patients -- at times in exchange for sexual favors -- was originally ordered by Headley to serve four years in the Indiana Department of Correction (DOC) followed by two years suspended and probation.

Howell, who initially faced 15 felony counts before entering into a plea agreement, has approximately one year of actual sentence time remaining.

In issuing his ruling Tuesday afternoon, Judge Headley noted that Howell's conduct during an Aug. 12 modification hearing was "not one of a person with all his mental faculties."

"The defendant's time left on this earth will be as a dementia patient with constant care needed," the judge added.

Appearing via videoconference from the Indiana Department of Correction facility in New Castle where he has been housed since March (after serving time at Plainfield previously), Howell appeared disinterested, often incoherent and more emaciated than his last in-person court appearance in mid-August 2012.

Central to the sentence modification argument of Howell's family and his Indianapolis attorney, Jay L. Clifford, was the worsening condition of his reported frontotemporal dementia (FTD).

Howell has never been released to the general population at New Castle, Headley noted, and has remained in the infirmary there due to his condition.

"Both the Department of Correction physician and the neurologist came to the same conclusion," Judge Headley's order stated. "The defendant's mental capacity is greatly reduced, will never get better and will continue to do so until death.

"The remainder of the executed portion must be at the facility, and not simply at home," the judge stressed. "Failure to stay at the nursing home facility shall be treated as a violation of probation."

Headley made reference to observations by Vicki Burdine, Indiana regional psychiatric director, and Penelope Wadleigh, nurse practitioner for the IDOC, in making his determination to convert Howell's remaining sentence into probation with the stipulation he must be in a nursing home facility for what would have been the executed portion of his sentence.

The report from Burdine and Wadeigh notes that Howell has no ability to read or write, is of "complete dependence on others around him to manage day-to-day living" and has been "taking a host of medication, some of which are known to be used in Alzheimer's patients."

They point to Howell's "significant mental incapacity and delusion," citing as an example, a comment he made at the infirmary at New Castle: "I am a mass of subatomic particles lying on this mat."

Meanwhile, Dr. Brandy Matthews, a board-certified behavior neurologist who saw Howell prior to his original sentencing, now recommends hospice care for him after observing his deteriorating condition.

Frontotemporal dementia, with which Howell has been diagnosed, is acknowledged as a "leading cause of early onset dementia," she noted.

Judge Headley also pointed out that the defendant's family is seeking a nursing home placement to be "paid from their funds, and not Medicaid."

At the Aug. 12 video hearing, defense counsel Clifford said because of Howell's condition, continued rehabilitation in the DOC would have no "meaningful purpose" for Howell.

Putnam County Prosecutor Timothy Bookwalter has voiced opposition to any sentence modification for the former doctor.

"I strongly object," he said previously. "This is just a rehash of excuses he gave at his sentencing. I have a hard time believing his alleged frontal lobe dementia made him proposition female patients for nearly a decade."

Investigators said unnecessary and excessive treatments and prescriptions administered by Howell were linked to sexual encounters with female patients at Tri-County Family Medical Clinic , which Howell operated in Roachdale for more than 20 years.

As part of a plea agreement in June 2012, Howell may never reapply for his medical license or DEA registration.

In exchange for the five guilty pleas, the state dismissed 10 other charges against Howell.

His arrest on Oct. 18, 2011 culminated more than a two-year investigation by local, state and federal authorities that revealed Howell overprescribed or unnecessarily prescribed narcotics that included Oxycodone, Methadone, Adipex, Clonazepam, Lortab, Vicodin, Alprazolam, Xanax, Percocet and Hydrocodone.