Aging population challenges public guardian
The aging population requires more social services, adult protective services and help from the public guardian, Bruce said during public comment at the Tuesday, Oct. 24 meeting.
The public guardian’s office actually handles income and bill paying for those with a demonstrated need for money-management assistance, such as public probate conservatorship services, mental health conservatorship services, institutional representative payee services and general consultation assistance to various government agencies and the public.
Clients are generally looking for solutions to problems facing low income and disabled persons of all ages. Roughly half its clients are 65 or older.
“In the last few years there’s been quite a few impacts from new programs and laws that have come down from the federal level,” Bruce said, “such as the HIPA Act, the Patriot Act, the Medicare D program and tighter regulations on MediCal eligibility.”
Every year, he added, the state of California adds new regulations that make the conservatorship process more complex and more difficult to establish and maintain. All the new regulations add to the amount of time it takes to serve the same people.
“If we don’t have additional time our caseload is going to have to be reduced somewhere,” Bruce said.
The latest law, AB 1363, which the governor signed in September, reforms conservatorships. Called the Omnimbus Conservatorship law, its reforms were designed to address recent high-profile cases of abuse by private professional conservators and outrageous fees charged against the state.
It also created new mandates for public guardians, including a 48-hour response time for new referrals. Bruce said the response time was unnecessary.
“Because we’re really not a first-responder type of agency, but that’s kind of where they’re pushing us,” he said. “The 48-hour response time already exists within the adult protective services agency and they to out and do a good job of investigating situations.”
When adult protective services generates a referral, Bruce said, he looks at it immediately and decides whether it’s appropriate for his services. AB 1363 will shift some of the burden of investigating cases to the public guardian. It also requires the public guardian to take some cases and removes Bruce’s discretion.
“In the past, public guardians basically have had the opportunity to look at a case and decide whether it’s appropriate for conservatorship, whether it can be managed by the public guardian and whether it’s appropriate for county guardianship.”
The language of the new law even includes a phrase requiring the public guardian to take “all needy cases."
The law also requires all public guardians to be certified through the public guardian’s association. Both Bruce and the deputy public guardian are already certified by the agency. But in the future, Bruce said the law could make it more difficult to hire qualified people.
“It goes without saying, coming from the state of California, there’s no money coming along with all these new mandates,” Bruce said. “As far as funding goes, we’re basically a general fund department.”
Bruce said he and his staff try to bring in money from other sources. One of the primary outside sources is known as targeted case management, where the public guardian finds funding from as many other sources as possible.
“Targeted case management is under attack by the federal government; they want to eliminate it,” Bruce said.
The federal government has reportedly hired 100 auditors to go through and audit all public guardian programs, he said.
“I believe their marching orders are to try to find money to come back. So that’s something that’s coming in our direction.”
Bruce said he hopes to find to new funding streams for the program and replace target case management with “something that’s better defined and a little more reliable.”
The bottom line, he said, is his staff is working harder to serve a smaller number of people as demands for services increase.
“If the demand increases sufficiently, we may be coming to you asking for more staff,” he said, “I’m not going to say that right now, but the writing is kind of on the wall.”
Funding will also be an issue, he said, until the state decides to fund the public guardian program.
With baby boomers turning 65, District 2 Supervisor Jim Chapman asked the board to put on its agenda a general discussion of how to fund services for the aging population. District 5 Supervisor Jack Hanson agreed.
"No community, including ours has taken this on,” Hanson said.
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