DAAS / PAGC CONSERVATORSHIP TRAINING Office of the Public Administrator/Guardian/Conservator November 4, 2020 (eaten eee ma mcr Ue Cle Kyle Anderson - Deputy Public Guardian/Conservator Perec uel sarc) County of Santa Clara© The Public Administrator /Guardian/Conservator provides programs that ensure the safety and well being for individuals who cannot do so for themselves. © The PAGC is governed by the California Probate Code and the Welfare and Institution Codes and only acts on behalf of an individual if appointed by the California Superior Court. © The Superior Court appoints the PAGC to act as a substitute decision maker through Conservatorships and through Public Administration. Department of Aging and Adult Services 2CONSERVATORSHIPS © Referrals are made from a variety of sources such as: = Hospitals = Skilled nursing facilities = Jails = California Superior Court = Adult Protective Services = Department of Mental Health © There are two different types of conservatorships: LPS and Probate Department of Aging and Adult Services 3LPS CONSERVATORSHIP © Lanterman, Petris, Short - CA state senators sponsors. CA Law (only) passed in 1972 - Established to arrange mental health treatment and placement for people who are gravely disabled and unable to provide for their food, clothing, shelter, and treatment needs as a result of a mental disorder (schizophrenia, bipolar, etc...) Can only be initiated by a psychiatrist while a patient is in an acute psychiatric hospital. © LPS Conservatorship referrals are only made after the involuntary hospitalization of individuals who meet the legal definition of danger to self/others or gravely disabled. Department of Aging and Adult Services 4PROBATE CONSERVATORSHIP © Probate Conservatorships are primarily established for frail adults who are unable to ane for their own personal needs (physical ealth, food, clothing, and/or shelter) or cannot manage their own finances or resist undue influence. Probate conservatorships are often used for individuals with severe limitations due to dementia or have serious cognitive impairments (stroke, severe trauma, etc...) © The purpose of probate conservatorship is to protect individuals, ensure shelter, food, clothing and safety. Also to provide medical care and protection of assets. Department of AgingPAGC STAFF Besides the Deputies and the Estate Administrators there are other staff members who contribute to the safety and welfare of our clients. + Appoint ippointed Public Administrator/Guardian/Conservator + Sworn cof Santa Clara County + DSW Chiet Public Administrator/Guardian/Conservato supervising Depul Public Guardian tnt Supervising Deput Public Guardian ongoing Supervising Depa Public Guardian Supervising Deputy Public Guardian ipervising Deput Public Guardian Eoobat Deputy Public Guardian-Conservators Estate Administrators © Over 100 Staff Total including + MHW 20+yrs DPG Assistants, Estate Administration Assistants + MSW, LCSW Estate Property Specialists + JD Clerical + RE License + CPA Management Finance Management Services, Taxes, Accounts Payable, and Accounts Receivable Legal Secretary, Executive Assistant, etc. Department of Aging and Adult Services 6A FEW STATISTICS @PAGC manages approximately $68,000,000 in client assets. Approximately 900 clients a year are served Case Categorization = 46% LPS » 31% Probate = 17% PA (Decedent) = 6% Trust Department of Aging and Adult Services 7FAST © In 1999, The Santa Clara County Financial Abuse Specialist Team (FAST) was formed. It is a multi-disciplinary team composed of members from PAGC, Adult Protective Services, County Counsel, and the District Attorney’s office and Sheriff Sgt. © The mission of FAST is to identify, investigate, prevent, and remedy financial abuse of elders and dependent adults. © The goal is to create a plan to prevent and stop financial abuse. Department of Aging and Adult Services 8CONSERVATORSHIPS LPSiS CONSERVATEE PRESENTLY GRAVELY DISABLED? © Grave disability & F/C/S = unable to provide food, clothing, shelter criteria for grave disability due to a mental illness = Conservatee lacks insight into mental illness = Conservatee feels he/she does not need medication = Conservatee cannot provide for themselves without medication and = Conservatee will not take medication without supervision of a conservator Department of Aging and Adult Services 12WHERE WE BEGIN © Client lives out in the community stops their medication and decompensates (psychosis, mania, delusions). © Client is taken (by police) to EPS - placed on a 5150 hold (72 hour). Client only worsens - is then placed on a 5250 hold (14 days) and admitted to acute psych. After 17 days of being involuntarily committed - client is still not well - can then be placed ona 5350 Hold = Temporary LPS Conservatorship. © Referral are made by a county designated “acute psychiatric hospital” = BAP 400/500, Stanford, El Camino, PAVA, Fremont, Jail 8A, etc... ** Cannot be initiated by public ** Department of Aging and Adult Services 1TEMPORARY LPS CONSERVATORSHIP © Public Guardians Office (LPS Intake Unit) now has maximum of 6 months to investigate client’s case. = Can they provide for this own care? Food, clothing or shelter = Can they live in the community? Clients can be homeless. = Is there 3 Party Assistance? © If the individual meets criteria for conservatorship once investigation has been completed the PGO will recommend to court that client be placed under a Permanent (1 year) LPS Conservatorship. Department of Aging and Adult Services 12“Handout GENERAL/PERMANENT LPS CONSERVATORSHIP © General or Permanent LPS conservatorships begin the day the court appoints PGO, this is always the same day the temporary conservatorship ends. © Each LPS general conservatorship lasts one year, it must be renewed each year or the conservatorship ends. © Conservatorships can be P only, P & E or Combo © Never Estate only (for LPS) © Murphy conservatorships*, Incompetent to Stand Trial, “Not Guilty by reason if Insanity” (NGI)* Department of Aging and Adult Services 13THE LANGUAGE OF LPS LEGAL PROCESS @ Reappointment = Reappointment/Renewal Each year, two doctors must attest that the client remains gravely disabled. Without these declarations from the doctors, the LPS conservatorship will expire. © Court / Hearings = LPS Calendar Weekly on Thursday afternoons. All reappointments, terminations, ExParte petitions, accountings, then any other hearings scheduled (except JT). = Summary hearing is when the client is given the chance to tell the judge what re/she thinks the Judge will find important. Judge rules on what is presented. = Less Restrictive Placement (LRP) is similar to a court trial, testimony by the doctor, the client and potentially the deputy. Judge rules on information given. = More Restrictive Placement (MRP) courts must be notified when a client has been at a more restrictive placement for more than thirty (30) days. = Status Review Check in with the court where the judge requests a status to be Sure everything is on track with court order of conservatorship, LRP's, etc. = Court trial are testimony with doctor, client and maybe deputy. Judge makes the ruling based on this evidence = Jury Trial each client has the right to a jury trial where a full jury will decide the clients Grave Disability (or not) based on testimony. Department of Aging and Adult Services 14ii! SS SSS SSeS SSS"Handout NEW 5 150 LAW (EFFECTIVE JANUARY 1, 2016) ARTICLE 1, Detention of Mentally Disordered Persons for Evaluation and Treatment [5150 - 5155] ( Heading of Article 1 amended by Stats. 1968, Ch. 1472. ) © 9. BANE aisaBed passe OME. profesional person in charge ofa facility designated by the county for ‘evaluation and treatment, member ofthe atending sf, as defined by sexlation, ofa facility designated by the county for evaluation and weatnent, designated members of a mobile isis team, or professional person tignated by the county may, upon probable ease, take, or eause to be taken, the person into custody fora period of ‘up wo 72 hours for aseatmont evaluation, and ris ntervetfon, or placement fr evaluation and weatment inf ‘tsignated by the county for evaluation and weatment and approved by the State Department of ealth Care Services. ‘Ata minimum, asessinent, as defined in Section 3150-4, and evaluation as defined in subdivision (a) of Section 5008, Shall be conducted and provided on an ongoing basi. Crist intervention, ar defined in subdivision (e) of Section 5008, ‘may be provided concurrently with assessment, evaluation, or any other service. ty (&) When determining ifa person should be taken Into custody pursuant to subdivision (a). the individual makin that termination shall apply the provisions of Section $150.05, (©) The professional person in charge of a facility designated by the county for evaluation and treatment, member of the tttending staf, or professional person designated by the county shall assess the person to determine whether he or she ‘can be properly served without boing detained. If, inthe judgment ofthe professional person in charge of the facility ‘designated by the county for evaluation and treatment, member of the attending staff, or professional perzon designated by the county, the person can be properly served without being detained, he or she shall be provided evaluation, crisis intervention, or other inpatient or outpatient services on a voluntary basis. ‘SHINE ENSUEGSTONSNAN Be (2) Whenever a person is evaluated by a professional person in charge of a facility designated by the county for ‘valuation or treatment, member of the attending staf, or professional person designated by the county and is found to be In noed of mental health servicer, but ix not admited tothe facility, all available alternative services provided ‘Pursuant to subdivision (c) shall be offered ar determined by the county mental health director, Department of Aging and Adult Services 16AUTHORITY OF CONSERVATORSHIP © Placement Authority - Deputy Public Guardian does not find placement for conservatees * SSA Referral Form - recommendation for 24Hour Care = Levels of Care * » Psychiatric Medication Authority - The right to force the individual to take psychiatric medications ® “Restrictions” - Firearms/weapons, DMV/CDL, Contracts, Routine Rx WE CANNOT CONSENT TO Medical procedures other than routine’. + Routine: Flu/pneumonia, lab work’, dental work, physicals, podiatry, optometry check ups, ete + Non-Routine: Surgery, cancer treatments, dialysis, diabetic treatments, colonoscopy, general anesthesia, “blood draw, ete. © Electro-convulsive treatment without a court order (even in probate this requires a court order) © Forcing a client to bathe* © Forcing a client to take non-psychiatric meds Special Powers © Non-routine medical procedure including surgery, treatments including medications. © DNR/DNI No CPR © Hygiene Care Department of Aging and Adult Services 17LPS TERMINATION & DISMISSALTERMINATIONS AND DISMISSALS ® Termination and dismissal are two legal terms for ending a General LPS conservatorship © Dismissal is done when the conservatorship is due for reappointment but the decision is made to drop the conservatorship © Terminations are done any time during the term of the conservatorship except at reappointmentWHO CAN TERMINATE A CONSERVATORSHIP © Only three individuals have the ability to terminate a conservatorship = Doctor (NGD), = Conservator (A/P, OOJ, decedent) =» Superior Civil Court - Probate Judge «= Jury Trial - Jury Verdict