Office of the Public Administrator Guardian/Conservator 2013 Annual Report

Transcription

1 Office of the Public Administrator Guardian/Conservator 2013 Annual Report Social Services Agency Department of Aging and Adult Services

2 Introduction The Children, Seniors and Families Committee (CSFC) last reviewed the Public Administrator/Guardian/Conservator (PAGC) Annual Report in November This report will update the Committee as to the status of current administrative and service issues specific to the PAGC program. PAGC, under the Department of Aging and Adult Services (DAAS), Social Services Agency (SSA), provides two primary services to the residents of Santa Clara County: Probate/ Lanterman-Petris-Short (LPS) Conservatorships and Public Administration. Conservatorships ensure the physical and financial safety of vulnerable adults who meet the legal criteria when there are no viable alternatives. Public Administration manages the affairs of residents who die without a will or without an appropriate person willing or able to act as an executor. The Public Administrator/Guardian/Conservator (PAGC) provides services that maximize the independent functioning of an individual at the highest level and with the least restrictive living arrangements possible. Services include, but are not limited to case management, placement, estate administration, court appearance, reporting duties, management of mental and physical health services and safeguarding real and personal property. PAGC Services and Oversight Conservatorship A conservator is given legal responsibility by the Santa Clara County Superior Court of a conservatee who has been deemed not competent to manage his/her own affairs. There are two types of conservatorships: Lanterman-Petris-Short Conservatorships (LPS) and Probate Conservatorships (Probate). LPS Conservatorships, named for the three assembly members sponsoring the 1969 legislation, were established to arrange for involuntary mental health treatment and placement for qualifying individuals and Probate Conservatorships were established to care for those adults unable to care for themselves due to severe limitations and/or serious cognitive impairments. The PAGC typically receives LPS and probate referrals only when support systems have failed and a person is in the worst possible situation without functional family supports. Since a conservatorship is usually seen by conservatees and family members as invasive, it is only established as a last resort. The first primary function of the PAGC is to investigate all referrals for conservatorship. Deputy Public Public Administrator Guardian Conservator Annual Report 2013 Page 2

3 Guardian Conservators verify the suitability of each referral with the goal of developing an alternate plan to avoid conservatorships by putting protections and interventions in place. Plans often include building a network to provide assistance to the client, such as establishing or re-involving a support system that agrees to provide oversight or a plan linking a client with community resources, such as care giving services, meal delivery, transportation, housing or legal resources. Deputy Public Guardian Conservators are able to develop alternate plans for 75% of the LPS referrals and 50% of the probate referrals, thereby alleviating the need for permanent conservatorship. LPS Conservatorships LPS is mandated by state law and was initiated to arrange for the involuntary hospitalization and mental health treatment of persons deemed gravely disabled as a result of a mental health disorder or severe and chronic substance abuse or alcoholism and are unwilling or incapable of accepting treatment voluntarily. An individual may only be referred to the PAGC by mental health professionals at designated acute psychiatric facilities after being evaluated for a grave disability, defined as having a mental disorder that keeps him/her from being able to provide food, clothing and shelter for him/her. By law, the PAGC must accept for investigation every referral for LPS conservatorship, with an average total of 400 referrals per year. In an LPS conservatorship, individual rights can be revoked. These rights could include the ability to enter into a contract and the ability to make personal choices about spending money. The privilege of driving a vehicle is definitely revoked when there is a permanent conservatorship. The loss of individual rights could also include the revocation of basic freedoms such as being forced to reside in a locked facility or being forced to take psychotropic medications. Mandates provide for prompt evaluation and treatment and safeguard individual rights through due process and judicial review, making it difficult to become a PAGC LPS client. The individual has the right to free legal representation and can demand a jury trial to contest a conservatorship. Probate Conservatorships Probate Conservatorships are primarily established for frail, cognitively impaired adults who are unable to provide for their own personal needs of physical health, food, clothing and/or shelter or cannot manage their own finances or cannot resist undue influence. Referrals may come from the community, hospitals or Adult Protective Services. A medical document from a physician as well as clear and convincing evidence of cognitive deficits must be found by the court in order to establish conservatorship. The conservator can make medical decisions but does Public Administrator Guardian Conservator Annual Report 2013 Page 3

4 not have the authority to place a conservatee in a psychiatric treatment facility. However, if a conservatee is wandering, getting lost or attempting to leave a facility thereby placing his/her health or safety at risk, the court can be petitioned for Dementia Powers to have the conservatee placed in a secure locked facility. While the law mandates that counties have a probate conservatorship function, it does not specify that every referral must be accepted for investigation. Probate receives on average 200 referrals per year. PAGC involvement is usually considered invasive by the proposed conservatee and his/her family. As with LPS conservatorships, the individual has the right to free legal representation and can demand a jury trial to contest the conservatorship. Public Administration The Public Administrator (PA) is mandated to provide estate closure services on behalf of deceased Santa Clara County residents when no one else is willing or able. California law states that if a person dies in a hospital, convalescent hospital or board and care facility without a known next of kin, the person in charge of the hospital or facility shall give immediate notice of that fact to the Public Administrator. Referrals can also come from funeral directors, law enforcement, the court, community or coroner s office. The majority of the referrals in Santa Clara County come from the coroner s office. Once a referral has been made, PAGC staff secure the decedents' home or apartment, begin the process of marshaling all the assets contained in the home and initiate an investigation to determine financial resources and locate wills, trust documents and/or heirs to the estate. If there are no heirs, or the heirs are unable or unwilling to act, the PA has the responsibility to make funeral arrangements as well as to take prompt possession or control of the property and all assets that are subject to loss, injury, waste or misappropriation. Oversight of PAGC The Santa Clara County Superior Court provides oversight and direction for the Public Administrator Guardian Conservator program. This is accomplished in several ways. First and foremost, the Court Investigative Unit conducts an initial investigation that is separate from the PAGC s initial investigation in order to insure that all alternatives have been considered, determine whether conservatorship is required and to provide insight to the potential conservatees needs. All potential conservatees are provided a hearing before the court, enabling opposing views and alternative plans. Once the PAGC is appointed as the conservator, court accountings must be submitted on an annual basis for new appointments and every two years thereafter for ongoing cases. The court accountings provide detailed financial information regarding the management of the case such as property sales, rentals, loans, reverse mortgages, healthcare, fees paid by the PAGC and fees charged by Public Administrator Guardian Conservator Annual Report 2013 Page 4

5 the PAGC. Accountings can be questioned by the clients appointed or private attorney and the judge will decide whether to approve, change, request additional information or deny. Annual Program Review The Office of the Public Administrator Guardian/Conservator office (PAGC) has made many operational adjustments over the past year. This report will provide a summary of PAGC program enhancements since the last report. PAGC Internal Audit Report The PAGC has responded to the entire 2010 audit findings and has incorporated the majority of recommendations into our operation. In a recent follow up by the Controller s Office it was determined that the remaining 28% of recommendations were partially incorporated or not yet completed. The PAGC anticipates that the remaining recommendations will be completed by July 2014, as indicated in our audit follow up report presented at the September 2013 Finance and Government Operations Committee (FGOC) meeting. In addition to the audit recommendations, the PAGC has been working with SSA s Financial Management Services (FMS) to provide financial oversight of PAGC Accounts Payable and Accounts Receivable units. All policies and procedures involving accounts payable and accounts receivable will be scheduled for review. PAGC and FMS anticipate a completion date of July In addition we are working with our Agency s Information Systems (IS) division and FMS to integrate financial automation into the Panoramic case management system, such as bond calculations and Systems, Applications and Products (SAP) interface capabilities. Attachment 1 titled PAGC 2010 Internal Audit Finding Status Report summarizes the Controller s Office internal audit findings and PAGC progress to date. PAGC Civil Grand Jury Report In May 2013, the PAGC received a report from the Civil Grand Jury titled Improvements are needed in the Office of the PAGC. The report noted 13 findings and recommendations for improvement. The report began by pointing out that the policies of the office had not been reviewed in several years. At the time the PAGC was in the process of reviewing all of its office procedures and has subsequently reviewed all case management policies and procedures and posted them to the SSA Intranet/PAGC homepage as Public Administrator Guardian Conservator Annual Report 2013 Page 5

6 requested. The PAGC has further implemented a new policy which prompts policy review on an ongoing basis; all polices must be reviewed every three years. The Civil Grand Jury report further recommended the development of a formal tracking system for complaints that come into the office. Effective June, 2013, a new system was implemented and all complaint calls received are recorded on a complaint disposition form and then forwarded to the Public Guardian for review and filing. The log is reviewed by the Public Guardian on a monthly basis for follow up and resolution. In addition, the Civil Grand Jury recommended that the issues preventing staff from fully utilizing the Panoramic case management system needed to be determined and that resources for oversight be provided. SSA Information Systems hired a full time position to work with Panoramic and PAGC staff to resolve three key issues: 1. Develop a more dynamic case coding system for report writing 2. Redefine system access rights for all users 3. Provide more systems training to staff This work is under way and moving forward. The Civil Grand Jury report also recommended a need for filing standards within the office. The Agency s, IS division has assigned a Project Lead who is currently working with PAGC staff to prioritize, organize and electronically store all client files on the agency main frame server. This will provide improved file maintenance as well as increase work efficiencies throughout the office. It was additionally noted that not all Deputy Public Guardian Conservators and Estate Administrators were certified through the California Association of Public Administrators, Public Guardians, and Public Conservators (PA/PG/PC) and that this should be a requirement. Administration agreed with this finding. Currently Staff Development and Training is coordinating a program that offers certification training opportunities for staff throughout the year. The Civil Grand Jury further noted that annual performance appraisals were not conducted despite existing contract language. In response, an Agency-wide project is underway to comply with this directive and the training of supervisors and employees has begun. During the course of the next 12 months all PAGC staff will have a completed performance appraisal on file. The Civil Grand Jury also pointed out that staff meetings were not held on a consistent basis. Supervisor monthly meetings and one-on-one review meetings with Public Administrator Guardian Conservator Annual Report 2013 Page 6

7 the Public Guardian are now in place and monthly staff meetings, held by all supervisory staff, are scheduled monthly and documented. The Civil Grand Jury report noted that the current time and attendance system did not allow for consistent information as to the whereabouts of employees in the field. The PAGC will be hosting a meeting with labor representatives and supervisors to work the details for a new time and attendance system that will meet this requirement within the coming month. Lastly, the Civil Grand Jury found the PAGC did not have an adequate training program for new hires. Staff Development is currently working with the PAGC to create a new hire training program that will provide training to specific job classifications as well as provide general orientation to both the program and department. Attachment 2 titled PAGC Grand Jury Recommendations Status Report summarizes the Civil Grand Jury recommendations and PAGC progress to date. New Legislation In August, 2013, Assembly Bill 937, sponsored by Assemblymen Wieckowski, was signed into law. It effectively amends existing Probate Code 2351 to read as follows: PC2351. The guardian or conservator, but not a limited conservator, has the care, custody, and control of, and has charge of the education of, the ward or conservatee. This control shall not extend to personal rights retained by the conservatee, including, but not limited to, the right to receive visitors, telephone calls, and personal mail, unless specifically limited by court order. The PAGC recognizes the change and will adhere to PC 2351 in its entirety. Non- Family visitation request are accepted unless refused by the client. Regional Training Conference The PAGC conducted a fifth annual regional training conference in September, The conference provides professional training that meets certification requirements and has been approved by the California Association of Public Administrators Guardians and Conservators. The conference was attended by Deputy Public Guardian Conservators and social workers from Santa Clara County. As in the past the regional training is open to several other Bay Area counties. Public Administrator Guardian Conservator Annual Report 2013 Page 7

8 Conclusion The Public Administrator/Guardian/Conservator program provides a vital service to the seniors and dependent adults in the community who are at significant risk due to physical, mental or financial problems that they cannot resolve themselves. Since the last annual report, the PAGC has been audited for both administrative and fiduciary issues and is now focusing resources to address and correct the noted deficiencies. The PAGC continues to monitor its Operational Enhancement Plan engaging all levels of program staff to further improve workplace efficiencies which ultimately provides better services amongst the staff and the clientele served program wide. In the coming months, the focus of the PAGC will be to continue to implement the various recommendations of both the Controller s Office and the Civil Grand Jury to enhance service delivery as well as partner with county and community partners. The PAGC has been working on several initiatives that will strengthen our communication lines with local senior advocates, client family members and our mutual partners. During the past year the PAGC has reached out to local senior advocates to work collaboratively on prescient issues such as conserved, isolated seniors. Such efforts when operationalized will provide both companionship and additional support to conserved individuals as well as provide further oversight in the facilities that provide care to our clients. Over the next twelve months the PAGC will work towards utilizing volunteer mediation services with greater frequency. To date, the service has been very successful in solving differences between family members and the PAGC program and will be a useful service to offer enhanced services. Additionally, the PAGC has been and will continue to work with our county partners (Mental Health and Health and Hospital System) to streamline the process of referrals that are made to the PAGC Probate Intake Unit. Seniors, who are in the hospital and in need of a conservatorship to help with placement and healthcare decisions, need to be addressed in a time sensitive manner. In a collaborative effort Valley Medical Center and the PAGC will collaborate to take a more proactive approach to referrals for conservatorship. The PAGC program s highest priority is to provide food, clothing and shelter to our clients and to ensure that they are able to live in the least restrictive environment. To maintain this goal, the PAGC will continue to improve communication between our program and the community of stakeholders to best serve this highly vulnerable population. Public Administrator Guardian Conservator Annual Report 2013 Page 8

9 Annual Data: PAGC Caseload Active Clients, June 2013 Active Percent of Total LPS % PA % Probate % Total 1, % Public Administrator Guardian Conservator Annual Report 2013 Page 9

10 PAGC Client Language Spoken Active Client Count by Case Type, Language as of 6/28/13 LPS PA* Probate Total Clients Percent of Total PAGC Clients American Sign Language % Cantonese % English % Farsi % Ilocano % Italian % Japanese % Mandarin % Other Chinese Languages % Other Non-English % Portuguese % Russian % Spanish % Tagalog % Unknown % Vietnamese % Total PAGC Clients , %** * PA clients are deceased; therefore their spoken language is often unknown. ** Sum is 100.0% due to rounding. PAGC Client Ethnicity Served Active Client Count by Case Type, Ethnicity as of 6/28/13 LPS PA* Probate Total Clients Percent of Total PAGC Clients American Indian/Alaska Native % Asian Indian % Black % Cambodian % Chinese % Filipino % Hawaiian % Hispanic % Japanese % Korean % Laotian % Other % Other Asian/Pacific Islander % Unknown % Vietnamese % White % Total PAGC Clients , %** * PA clients are deceased; therefore their Ethnicity may be unknown. ** Sum is 100.0% due to rounding. Public Administrator Guardian Conservator Annual Report 2013 Page 10

11 Client Asset Value The following chart represents $62,787, worth of client assets managed by the PAGC program as of August 8, There was a significant increase due to the lack of brokerage information available in the case management system for FY All brokerage data is current and reflected in the Panoramic Case Management system. PAGC Client Asset Value as of June 30, 2012 PAGC Client Asset Value as of August 8, 2013 Total Amounts Total Amounts Non-Final Status Inventory $45,972, Non-Final Status Inventory $48,690, Brokerage Statements $0.00 Brokerage Statements $14,097, Total Inventory $45,972, Total Inventory $62,787, Total Inventory 2012 $45,972, $62,787, $0.00 $20,000, $40,000, $60,000, $80,000, Public Administrator Guardian Conservator Annual Report 2013 Page 11

12 Financial Abuse Specialist Team (FAST) For over ten years the mission of FAST has been to protect those seniors of Santa Clara County who are the victims of financial abuse by providing rapid intervention when financial abuse is reported to Adult Protective Services. The FAST approach to financial abuse of the elderly has had a successful history as indicated by the number of dollars protected over the years between May 1999 through September FAST RECOVERED AND/OR PREVENTED THE LOSS OF $221.3 MILLION Real Property $136,698,800 Liquid Assets $30,971,308 Stocks $40,412,004 R/R/S* $13,239,559 TOTAL $221,321,671 *Restitution/Recovery/Settlement Stocks 6% Liquid Assets 27% R/R/S* 7% Real Property 60% PAGC Fees Posted and Deferred The PAGC does have a fee schedule for various work performed by staff on behalf of our clients. The fees are posted to the clients account and collected via court approved accountings, submitted by the PAGC. However, a large portion of our caseload is unable to pay for these charges for a number of reasons, such as: 1. Overpayments that must be repaid 2. Healthcare Services Expenses 3. Food, Clothing, Shelter Expenses 4. Tax Debt 5. Funeral/Burial Expenses 6. Transportation Expenses 7. Debt (e.g., Taxes, Mortgage, Credit Cards, Insurance) Public Administrator Guardian Conservator Annual Report 2013 Page 12

13 PAGC Fees Summary FY 2012 FY 2013 Fees Paid $1,305, $1,387, Fees Deferred $1,283, $1,744, Total Fees $2,602, $3,132, The bar graph provides data for the total amount of fees that have been posted to the client accounts and the total amount of fees that have been deferred for the FY 2012 and PAGC Fees Summary Fees Paid $1,305, $1,387, Fees Deferred $1,283, $1,744, FY2012 FY 2013 Total Fees $2,602, $3,132, $0.00 $500, $1,000, $1,500, $2,000, $2,500, $3,000, $3,500, Public Administrator Guardian Conservator Annual Report 2013 Page 13