Turns out there's been two cases in the last ten years of guys like Andy trying to fake incontinence to get their rocks off. They get caught and go to jail, thank fuck. First one is out of AZ, and he horrifyingly worked as a sub for a school district before deciding to pull an Andy at 30 years of age.
This guy was busted back in January, but it wasn't his first offense. He was trying to (or did) hire caregivers online for diaper changes. Mercifully this attempt was short lived, but damn, Louisiana. Throw away the key this time.
https://www.wdsu.com/article/louisiana-man-history-diaper-changes-rutledge-deas/70203106
In facilities, when guys like Andy pop up they are dealt with by the male staff. Exclusively. There may even be rules about being in room with him as a female that you have to be 2:1 or even 3:1 for safety. The fact that he refuses to call them briefs, the insistence on female staff...all of if would get him flagged in a facility so fast.
So I am naively optimistic there is way more control in place to keep caregivers safe in a home visit environment, even if it's just mandatory 2:1 and only males when available. There may be more they can do, idk.
Either way, it sounds like the clock is running out on his time in Erie. Whether he leaves via jail or bus is up to him, I guess. Also Tawm doesn't have to be his payee if he doesn't want to. He can refuse. Make the state do it. Cut every single last tie if he wants.