PAGCPublic Administrator/Guardian/Conservator

Department of Aging and Adult ServicesSanta Clara County - Social Services Agency

2017annual report

TABLE OF CONTENTS

Introduction

Operational Highlights and Accomplishments

Serving Clients, County Partners, and the Community

Empowering Staff

Transforming through Innovation and Technology

PAGC Case Snapshots

Financial AbusE Specialist Team (FAST)

PAGC Staff

Program Descriptions

Conservatorships

Charts and Graphs

Estate Administration

Public Administration

Court Accountings and Fee Collection

Urgent Needs Fund

Oversight of PAGC

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INTRODUCTION

During 2017, the Office of the Public Administrator, Guardian, Conservator (PAGC) has continued to work towards goals consistent with Santa Clara County Social Service Agency’s strategic vision to serve customers, empower staff, and transform operations through innovation and technology. It has been a busy and rewarding year, with many improvements and new ideas, which are outlined and described on the following pages. The PAGC is particularly focused on our Systems Improvement Plan (SIP), collaboration with Behavioral Health and Valley Medical Center (VMC), and working with Moran Consulting to improve workplace relations as well as PAGC’s internal and external customer service.

This report begins with PAGC’s operational highlights and accomplishments, presents a snapshot of PAGC’s good work and distinctive cases, and defines the PAGC program. Charts and graphs underlining the numbers and demographics of the division are also included.

It is important to note that the PAGC actually contains three programs that in other counties are often divided amongst several departments. This makes Santa Clara County PAGC a particularly unique, multifaceted and complex program, serving adults who cannot care for themselves due to mental illness and/or dementia, brain injury or other cognitive impairments. In addition to serving vulnerable adults, the Public Administration division executes the estates of deceased Santa Clara County residents when no one else is capable or willing.

These services are made possible through the generosity of the Santa Clara County Board of Supervisors and in particular the dedication of PAGC Deputies, Estate Administrators, Estate Property Specialists, support staff, and management. In addition, County Counsel, PAGC Financial Management Services units, Information Systems and Adult Protective Services work closely with us as we assist residents at-risk of abuse and/or self-neglect.

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Systems Improvement Plan (SIP)

Continuing PAGC’s efforts to add meaningful structure and improved processes to serve clients and the community more efficiently and effectively, a SIP plan was agreed upon by PAGCand DAAS management. The three priorities identified for the coming year are:

1. Court Accounting Compliance – It was brought to the PGO’s attention that there were continuances of court accountings, which resulted in a backlog of accountings that did not meet the yearly and biennial compliance dates set by probate code. It became evident that the problem is complex, because as the accounting process progresses, it is touched by numerous hands; deputies, estate administrators, legal secretaries, supervisors, the accounting division, county counsel, etc. The first step was to find out how many accountings were out of compliance and then to ascertain what is causing the postponements. FMS and PAGC are working together to identify the main points of delay and to streamline or change processes to address the blockages. For example, a pilot program was created to test whether changing the Inventory and Appraisal (I&A) routing system by one unit would decrease the processing time for an I&A.

2. Closing Public Administration (PA) Cases – The PA unit is mandated by the State to administer the estates of Santa Clara County residents who have died with no one capable of closing the estate on their behalf. The PA unit is charged with the task of settling the estate from burial to distribution of assets, including finding heirs, marshalling assets, selling houses, liquidating securities, etc. Most cases take two years to close and the more complex may take three, but as staffing challenges and increased referrals occurred, an unacceptable backlog developed. Hard to close cases lingered on the shelf and more and more cases over 4 years old resulted. The PAGC is addressing this problem with a plan to review older cases on a weekly basis and to identify impediments to closure and initiate solutions with the help of County Counsel and the use of extra help. The goal is to have no case over 3 years old by the end of the fiscal year.

OPERATIONAL HIGHLIGHTS AND ACCOMPLISHMENTS

Serving Clients, County Partners, and the Community

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3. PAGC Warehouse/Inventory Issues – Inventory of clients’ property both living and deceased is a process that requires accuracy and thoughtfulness. Clients and family members are concerned about possessions such as furniture, memorabilia, jewelry, collections, etc. and these possessions must be documented and safe-guarded until decisions are made regarding the client’s living arrangements or, in decedent cases, until heirs are located and distribution sanctioned by the Court. The inventory procedures were rewritten by management last year and a new process implemented to ensure greater documentation of what is stored in the warehouse. The PAGC is now working with FMS and IS to identify how the applications system, Panoramic, can better serve our inventory needs. How other counties manage their clients’ property will also be studied.

Partnering with Behavioral Health and Valley Medical Center (VMC)

Clinical Risk Management – In March, 2017, representatives of Behavioral Health, the PAGC, VMC, and County Counsel began meeting bi-weekly as part of a Clinical Risk Management team to discuss services to clients whose treatment crossed these sections of County services. Included were hard-to-serve clients and difficult to place, such as those coming from the jail and those with severe behavioral problems. A draft contract between the County and Telecare, a contractor who provides services to mentally ill clients, was created to define the County’s expectations of the contractor, which reflected State requirements of licensed facilities. County Counsel researched the legislative history of client placement and provided a written legal analysis to guide policy decisions regarding facility usage. A greater understanding of each department’s responsibilities and limitations was realized over the three months that the group met.

County Leadership Meeting on PAGC and Health and Hospital Complex Client/Patient Placements – In April, 2017, the PAGC, Behavioral Health, VMC, County Counsel and the County Executive’s Office, began to meet to strengthen collaboration among the PAGC, Health and Hospital System, Office of Supportive Housing, County Counsel and the County Executive Office to address the placement of clients/patients with complex care needs. A clinical flow chart for patients with psychiatric and/or behavioral issues was developed, Behavioral Health increased the patch rates for licensed board

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and care facilities to assist placement of clients, the issues involved in trying to place clients with behavioral problems under probate conservatorship were examined and the need for facilities was a frequently discussed subject. These meetings continue and a cross system care coordination team for challenging clients is being identified and created in which PGO will participate.

True Link Services

The PAGC announced the True Link Services program in last year’s Annual Report. Since the PAGC is responsible to monitor consevatees spending and provide them with personal needs money each month, True Link greatly benefits the relatively high functioning conservatees in independent settings. This program is a financial services company that protects vulnerable individuals from becoming victims of fraud, scams and exploitation. The True Link card simplifies fund distribution and saves staff time by reducing administrative tasks. The company provides tools that can be self-managed by a conservatee or managed by Deputy Public Guardian Conservators (DPGC). With True Link, PAGC staff is able to protect client’s independence and their assets. The card is easy to customize and meets the specific needs of each conservatee. Purchases at specific stores can be blocked while other stores can have approved expenditures for specific items. DPGC can disable the card and obtain alerts, if needed. Last year the PAGC had 10 clients using the card and this year we have approximately 45. The plan is to expand to as many clients as appropriate and to move away from the use of cash almost entirely.

Embrace a Senior

Santa Clara County PAGC is sponsoring its second annual special holiday project called Embrace a Senior. This project is specifically designed to collect donations and distribute holiday gifts to seniors, cognitively impaired persons, and mentally ill people representing Santa Clara County’s wide range of socio-economic and ethnic populations. Our goal is to provide a meaningful gift to our clients, who may not have family, may be estranged from their loved ones, and/or whose families are financially unable to provide presents.

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Community Outreach and Training

The PAGC’s contact with the community has been extensive this year. These contacts take the form of phone calls to the PAGC and presentations and trainings by PAGC staff. The PAGC receives many calls from the community inquiring about conservatorships for a loved one, neighbor, patient, or friend. Educating our community is critical to establishing appropriate conservatorships. The communication between our intake supervisors and residents of Santa Clara County demonstrates transparency and collaboration in the process and promotes callers’ understanding of the basics and parameters of a conservatorship. The LPS intake unit and the Probate intake unit staff speak with people on a regular basis about placement options, problem solving, information and resources, and court processes. This year, we have documented over 400 community calls to our intake units.

Staff has been generous in their response to requests for presentations and trainings. PAGC’s probate intake supervisor alone has visited Stanford, Kaiser, San Jose Regional and the Veterans Administration to train staff on making a conservatorship referral and how to complete a Capacity Declaration. The LPS supervisor has presented at Stanford Hospital and Santa Clara County Family Health Plan on both LPS and Probate Conservatorships. Staff members have trained community partners at Momentum and the San Jose State University Social Work Program. In a team effort to educate internal County programs, such as Behavioral Health, the jail, the County Executive’s Office, etc., over 20 pages of power point were prepared on the conservatorship process for the Jail Diversion and Behavioral Health Committee of the Reentry Network Program. PAGC believes that through these education efforts our community can better understand the conservatorship and Public Administration processes.

Extra Help

Again this year, the PGO has used extra help to support staff and the work of the PAGC. Six extra-help workers have been essential in helping to close PA cases; assist clients at doctor’s visits, shopping for food, clothing and necessities; visiting the lonely or sick; helping to socialize; etc. The request for extra help was needed as Deputies and EAs found it increasingly difficult to keep up with complicated and time consuming cases. In addition, finding appropriate and qualified staff replacements for open positions in PAGC’s very specialized work has, at times, been difficult. The massive work of updating and writing policies and procedures is being accomplished through a MAPM III extra help position, since there is not a dedicated management analyst in the PGO. These extra help workers, along with three efficient and energetic interns, have helped to relieve some of line staff’s workload and provided better oversight and contact with PAGC clients.

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Oath of Office

On Wednesday, July 26, 2017, PAGC staff members took an Oath of Office, as required by Government Code and the California State Constitution. This oath is required of any PAGC staff member who enters client’s homes and/or manages client property or assets. At the monthly all-staff meeting, Public Guardian, James Ramoni, administered the oath after the Chief Deputy PAGC explained the seriousness and significance of the Oath. “Powers, Duties and Liabilities of a Sworn Deputy” was provided to staff and discussed before the administration of the oath. Additional dates were made available in September and November for staff members who were absent and for newly hired staff. The Oath of Office is now part of the County of Santa Clara’s PAGC induction process.

Regional Conference 2017

The Santa Clara County PGO assembled and hosted the annual Northern California Regional Conference in June 2017. This was another great conference with fabulous attendance and workshops. Approximately 100 people attended each session and represented seventeen counties. Workshops included Interpreting Neurological Evaluations, Depression, Loneliness and Suicide in Adults, Ethics in End of Life Decision Making Common Medical Conditions and Prescription Medication in the Elderly and Landlord and Tenant Rights. The Conference has been so successful that we have outgrown the Social Services Auditorium and will be hosting the 2018 conference at a new location.

Policies and Procedures

In January of 2017, we began working with Lucille Lyon, an expert on State Probate codes and regulations, as well as PAGC “best practices” to update and improve our Policies and Procedures. A former Chief Deputy Public Guardian/Public Administrator for Orange County and Riverside County, Ms. Lyon has generously

Empowering Staff

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shared her expertise. One of the highest achievements in the last year has been the creation of Policies and Procedures for the area of Public Administration (PA). This has been a joint effort combining Ms. Lyon’s skill with the knowledge and experience of our Public Administration staff and supervisors who have been invaluable as subject matter experts for Santa Clara County PA processes. The outcome is a thorough, thoughtful and detailed collection of formal policies and procedures along with the accompanying documents, letters and forms. In addition, a thorough review of our existing LPS and some Probate policiesand procedures is underway with the expert help of LPS and Probate supervisors and staff. We are excited that in the near future, we will be able to add these Policies and Procedures to the PAGC Toolbox, where they will be easily accessed by staff and more simply maintained and updated. As an interesting note, Ms. Lyon lives in Riverside County, and has done much of her work with our county remotely. She has visited our office five times in the last 10 months, and will visit again in December.

Regional Meetings/Coffee Hour Bring State PAGCs Together

Santa Clara County PAGC has hosted a quarterly regional meeting with other Bay Area Public Guardian offices for several years. This has been a great way to share ideas and practices, to brainstorm solutions to common problems, and to network. Beginning in March 2017, the California State Association of Public Administrators, Public Guardians and Public Conservators began hosting a monthly video/phone conference “Coffee Hour” which has taken the place of our quarterly regional meetings. This has become an important opportunity for all the counties in the state of California to suggest agenda topics, and provide information to one another about various practices, resources and policies in different offices.

Santa Clara County has been an active participant in these monthly video/phone conference meetings. Not only have we suggested agenda items (such as, “banks refusing PG/PC’s access to clients’ bank accounts”), but we are often a resource, as well. Topics discussed during these video conferences range from “Tracking tax filing status,” “Dealing with firearms in an estate,” and “LPS placements” to “Medallion signature authority,” “Fee schedules” and “Using pre-paid debit cards for client spending.” It is exciting to be able to utilize technology to connect so easily with other

offices in the state and develop contacts with people who are truly experts in the field. Video of these “Coffee Hours” is archived on the State Association website (http://capapgpc.org) where members can go back and view the meetings. As well, the member counties have shared various resources that are also stored on the website as reference material for others.

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PAGC Online Toolbox Helps in Organization

The Toolbox Workgroup has been working since March 2016 to develop a Toolbox for PG staff and in July 2017, it went LIVE. The voluntary workgroup made up of workers and supervisors from all of the units in the office met weekly to create the toolbox that will assist staff with common workplace questions. Staff is now able to easily find forms, legal matters, resources and Procedures. The Workgroup continues to meet and work on updating internal forms. Four members of the workgroup have been trained in SharePoint and are now the Administrators for the site.

Telework Improves with PAGC’s Collaborative Efforts

In accordance with County’s commitment to the environment, State Assembly Bill AB32 (reduction of greenhouse gasses by local governments), and SCC Master Contract (8.18) – The PAGC piloted teleworking in 2014, and in 2015 (through a joint collaboration between management and staff) the PAGC adopted its own specific Teleworking Policy. Reflective of the complex work at the PAGC, it was felt that the division should go above and beyond the county’s general teleworking policy to assure Telework would not hinder the multiple programs found in the PAGC. The PAGC policy codified staff’s proposed “work goals,” as well as ongoing supervisory review for accountability as to the effectiveness and productivity of teleworking.

Currently the PAGC has 14 staff teleworking (1 to 2 days per week). While there is a total of 75 staff members in PAGC, only some positions lend themselves to teleworking. Through the use of modern technology (laptops, smartphones, MiFi cards, Remote Access, OWA, Cisco Jabber, E-fax) staff are able to both complete their work and stay in constant communication with colleagues, supervisors, vendors, and clients in a seamless manner, whether at their home office or the Julian Street worksite.

Teleworking at PAGC has been a highly successful program with management and staff working together (from pilot to policy) to balance work flexibility, efficiency through technology, and accountability of actions, The PAGC is doing its’ part as a “green” office and, most importantly, without sacrificing any PAGC service or client care.

Transforming through Innovation and Technology

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Data Recovery Technology an Added Investigation Tool

Over a year ago, the PAGC formed a new team and established a designated room as part of the Data Recovery Technology (DRT) program. Since then, California Probate Code 871, the Digital Access Act, became effective January 1, 2017 and the Santa Clara County PAGC became one of the first counties to formalize a DRT team and incorporated it into their Policy and Procedures. The PAGC is now in the process of ordering specific tools needed by the Team to retrieve data from desktops, laptops, memory cards, loose hard drives and similar devices. Because of this valuable tool, an estate administrator was able to locate an account worth approximately $300,000, for a client who had fallen victim to elder financial abuse. Investigators are privy to information, which previously may have gone undiscovered. Having worked with Information Systems to set up a specific room and computer for data recovery, the PAGC staff has now made it a standard operating procedure to secure computers and scan their contents for valuable information almost immediately and the PAGC can be assured that a thumb drive can be plugged in without the worry that sensitive private information and/or destructive viruses will compromise or damage the County’s greater computer network system.

New PAGC 2017 Dashboard

PAGC worked with Social Services Agency Information Systems Department (SSA-ISD) to develop a web based dashboard and detailed reports to aid in providing strategic and analytical information about current status, historical PAGC trends, and performance measures using the department case management system. In June 2017, SSA-ISD started collecting data for the dashboard and the result of this data is represented in some of the graphs used in this report. The dashboard allows PAGC to identify key performance measures, identify fields and criteria for detailed reports, gather requirements to design and develop improved service to clients and validate required service delivery such as visitation and quick referral response.

Online Auctions Benefit Clients and the County

PAGC is using an online auction to sell items on behalf of conservatees and decedents served by our office and its success is more than we anticipated when we joined GovDeals over a year ago. Since the PAGC began using this vendor, we have made $169,514.00 for our clients, which goes directly into their accounts. No longer is a commission charged as in live auctions (35%), for fees are paid by the buyers. No longer are items stored for long periods of time as they await a biennial live auction, since property can be listed online with a click of the mouse. With thousands of internet buyers bidding, the profits realized are considerably higher than the profits received from live auction sales that were attended by fewer than 100 bidders in the

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PAGC and the VA Join Forces to Save a Deceived and Desperate Client

Margaret was in the hospital recovering from surgery, when her granddaughter, Tisha, deceived her into signing a general Power-of-Attorney. Unbeknownst to Margaret, Tisha executed the Power-of-Attorney and granted title to Margaret’s home to the grandfather, Margaret’s estranged husband, and Tisha’s mother, Margaret’s estranged daughter. Upon Margaret’s release from the hospital, Margaret arrived at her home only to discover she would be denied entry and access, because it no longer was hers, but occupied by Tisha and her mother. Margaret went to a shelter and then rented a small studio, which exceeded her monthly income. Her health deteriorated as she stopped necessary prescriptions and stressed over her granddaughter’s betrayal and her looming homelessness.

Her plight was reported to Adult Protective Services (APS) as a financial abuse case. As a member of the Financial Abuse Specialist Team, the PAGC deputy worked with Margaret in seeking solutions and discovered that Margaret was a veteran. Acting closely and diligently with the Veterans Administration (VA), the deputy was able to identify and secure alternative housing for Margaret, who served honorably in the United States Navy.

PAGC CASE SNAPSHOTS

Working to Improve the Lives of Others

past. GovDeals sends PAGC a check made out to each individual client, as well as a bill of sale. This keeps the process simple for SSA’s Financial Management Services, which assists PAGC clients by depositing checks and documenting transactions related to their accounts. Property that went unsold at onsite auctions, would typically be donated. Now most items are sold easily on GovDeals.

There are times when property must be kept in safekeeping for PAGC clients. Marshalling assets is mandated by Probate Code. Clients may be in transition from one placement to another and they may hope to return home with their personal items that may have useful and/or sentimental value to them. In addition, in both decedent and conservatorship cases, families and heirs are to be identified and their wishes considered. There are times, however, when assets are sold for the “advantage, benefit, and best interest of the conservatee” (Probate Code 2541) and to settle decedent cases, after consultation with heirs. In these cases, the PAGC’s new use of the internet site, GovDeals, has proven a “win-win” situation for clients and the PAGC.

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The proposed conservatee was given shelter at the Homeless Veterans Emergency Housing Facility, where she will continue to reside for two years. After the duration of her stay, Margaret will receive a free housing voucher to assist her with re-establishing and rebuilding her life. Living now in a safe, supportive, affordable, and comfortable living environment, she expresses gratitude and has regained the dignity that she feels she lost through the betrayal of loved ones. With free medical and dental benefits and a reduction in stress, Margaret no longer feels hopeless and can care for herself, without conservatorship. She rests assured that there are those, like the PAGC and the VA, who are there to help in times of despair.

Going the Extra Mile for Client and Pup

Edith is 71 years-old and has lived alone in her home for 40 years. Observing her anger and volatility, Edith’s neighbors worried about her well-being and that of her beloved dog, Daisy. She came to the attention of PAGC as a referral from Valley Medical Center (VMC) after numerous holds for being gravely disabled and /or unable to explain how she would provide care for herself. Edith would typically call 9-1-1 Emergency to report that people were looking in her windows or had severely beaten her in her home. Police reports indicated that her delusions were becoming more frequent. When the PAGC deputy met Edith, the deputy reported that there was no fresh food available in the refrigerator, all the contents were spoiled, dishes were piled in the sink, the house was extremely dusty and dog feces covered the carpet. Large wine bottles cluttered the home.

The Deputy Public Guardian arranged for clean-up of Edith’s home and hired caregivers to provide food and attention to Edith’s needs. However, Edith did not want others in her home and locked the caregivers out, chased them away and continued to drink heavily. Under doctor’s advice, the deputy knew that Edith needed a different environment where she would be safe and free from substance abuse. The facility would need to be locked to prevent Edith, who suffered from hallucinations, from running away and hurting herself. Wanting to do what is right, but adding difficulty to the task, the deputy decided that Daisy was integral to Edith’s health and welfare. Daisy was one of the few elements of Edith’s life that brought her happiness. After much effort, an appropriate facility was found and Edith was transferred, but Daisy would have to be boarded, since she needed shots and would have to undergo a “meet and greet” with

other pooches at the facility. Recently, the PAGC was notified that Daisy passed her good behavior test and would soon be reunited with Edith. There was thought that Edith might not remember Daisy due to her dementia, but a shared video of a tearful Edith and her jubilant Daisy left no doubt as to the impact of the deputy’s decision to go the extra mile.

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Safety and Caring Pays off for a Willful and Unhappy Client

Rosa is childlike in many ways. Both obstinate and independent, she did not want to be conserved, but others were controlling her for personal gain and she needed safety and protection. After her brother died, she continued to live in their hillside home, which has several levels of flooring. She has a history of falls, but chafed at receiving 24/7 care and continued to act as independent as possible. Seeing a branch of her tree that required pruning, she climbed into the tree to do the job. Her fall resulted in a fractured hip and she began the long road to rehabilitation. Rosa’s impatience took the form of a hunger strike and she lost 10 pounds from her tiny frame, however, the house with its multiple levels posed an obstacle to her safety and a more suitable placement was considered. Her deputy knew Rosa was unhappy and wanted to be in her own house, so the deputy and estate administrator worked to consider options for her return home. Safety ramps were researched, bars were considered, and an elevated and dangerous bathtub was evaluated. Soon workers were hired to perform all the necessary safeguards and Rosa was able to return home. She is eating now and will spend Thanksgiving and Christmas at the home of a dear

friend, who was the first to report Rosa’s abusive conditions to the Department of Aging and Adult Services.

A Celebration to Remember

Abdul did not have a happy childhood and had been estranged from his family for some time. His PAGC deputy assistant (DPGA) was visiting and asked if there was anything he would like, given the small amount of funds in his LPS conservatorship account. Abdul, who rarely asked for anything, thought for a moment. His birthday was approaching and he made comment to the DPGA that he never had a birthday party in his entire life and that a little cake to share with those in his board and care would be nice. The DPGA, touched by his simple request, decided that plans for a real surprise birthday were in order. On the day of Abdul’s birthday, the deputy with the help of the facility management organized other clients to join in the surprise. When Abdul entered the room, he was stunned by what he saw. There before him was a room filled with colorful balloons, decorations, a birthday cake and best of all, a rousing and unmelodious rendition of “Happy Birthday to You” from friends and staff conjoined. Abdul was overwhelmed with happiness and christened the day as the “Best Ever”! PAGC staff understands that sometimes it is the little things that make the biggest impact in the lives of those we serve.

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After initial vetting by Adult Protective Services (APS), 46 cases were investigated by the FAST team in the past year. Each referral receives a thorough investigation, which typically includes multiple interviews, visits to financial institutions, researching legal documents, financial statements and other memoranda associated with the alleged abuse. FAST Team members (Deputy Public Guardians Conservators, Estate Administrators, and APS Social Worker) follow a twofold approach for each case: (1) determine if there has been fraud, theft, or other criminal activity; and (2) determine if the victim is in need of a conservatorship. Both County Counsel and Deputy District Attorneys are present to discuss the case. Once fraud, theft, embezzlement, etc. has been detected, the Team develops a plan to protect the victim’s remaining assets and discusses an approach to recover stolen property.

The Public Guardian has extraordinary (statutory) powers to freeze, collect or otherwise protect assets at risk. This could involve exercising the authority to freeze bank accounts, preventing transfers of investments or interceding and preventing a fraudulent real estate transaction from being completed.

There are several possible outcomes from a referral for FAST Investigation:

• The allegations of financial abuse are determined to be unfounded. In some instances, there has been a misinterpretation of the facts, or more commonly, cross-allegations are made by siblings/beneficiaries, against each other;

• The allegations are determined to have merit and assets are at risk. The victim may have dementia, or other cognitive deficiencies, but there are less intrusive vehicles available to protect the individual and their property than a conservatorship (appointment of a fiduciary, power of attorney, appointment of a trustee or successor trustee);

FINANCIAL ABUSE SPECIALIST TEAM (FAST)

Outcomes of FAST Cases

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• The allegations are determined to have merit and assets are at risk. The individual will be evaluated for conservatorship. A thorough screening and assessment will take place before the court hearing is held. During this period of time, the Public Guardian will exercise its extraordinary powers to protect assets, and will enlist any necessary services to ensure that the proposed conservatee is safe and has proper care in place; or

• The Public Guardian may be appointed temporary conservator or a family member or other party may be appointed by the Probate Court to be the conservator for a variety of reasons. In very rare instances, a conservatee may have stabilized and gotten their estate in order, so that they are no longer in need of a conservatorship.

FAST Assets Recovered and/or Loss Prevention

The investigative process, as well as the appointment of Conservator and the managing of a conservatee’s estate, may take weeks or months. In Financial Abuse cases, the Public Guardian may file an action to recover conservatee’s property, or there may be a criminal prosecution and restitution ordered. In many such cases, the assets are gone and the Public Guardian must develop a plan to pay for the care and other needs a conservatee will have for the rest of their life. This entails creative, conservative, case management and long-range planning.

In FY 2017, PAGC prevented the loss of and recovered a total of $30,179,883 in assets, which are a combination of real property, liquid assets, stocks and bonds, and restitution, recovery and settlements. Since the FAST program began in 1999, PAGC has prevented the loss of and recovered assets totaling over $331,845,554.

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PAGC STAFF

The office of the PAGC is comprised of 84 employees.A new Deputy Public Guardian Assistant code was created in Fiscal Year 2018.

1 Chief Deputy Public Administrator/Guardian/Conservator

12 Estate Administrators

6whomanagetherealpropertytrusts,securities,andassetsofclients

6whomanageDecedentEstatecases

2 Estate Administrator Assistants

4 Estate Property Specialists

2 Deputy Public Guardian Assistant

31 Deputy Public Guardian Conservators

1 Office Management Coordinator

1 Executive Assistant

1 Administrative Assistant

1 Legal Secretary II

2 Office Specialist IIs

9 Office Specialist IIIs

1 Social Services Program Manager II/I (overseeing Estate and Public Administration)

1 Social Services Program Manager III/II (overseeing LPS and Probate)

4 Supervising Deputy Public Guardian Conservators

2 Supervising Estate Administrators

2 Extra Help Estate Administrators whomanageDecedentEstatecases

2 Extra Help Social Workers I

1 Extra Help Deputy Public Guardian Assistant

1 Extra Help Management Analyst Program Manager III

3 MSW Student Interns

75 Total Permanent Positions

84 Total PAGC Staff

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The Office of the Public Administrator/Guardian/Conservator (PAGC) is under the Department of Aging and Adult Services (DAAS), Social Services Agency (SSA) and provides essential programs for residents of Santa Clara County to ensure the safety and well-being of individuals who cannot care for themselves. The PAGC is governed by the California Probate Code as well as the Welfare and Institution Code and only acts on behalf of an individual and/or an individual’s estate if appointed by the California Superior Court. The PAGC is accountable to the Superior Court and is represented by SSA County Counsel. The Superior Court appoints the PAGC to act as a primary decision maker for Conservatorship and Public Administration cases.

The residence of the client at the time of commencement proceedings is often presumed to be the appropriate and least restrictive residence for the conservatee. Upon appointment, the PAGC shall determine the appropriate level of care, taking into account all of the circumstances of the client, including, but not limited to the clients financial means and medical needs.

PROGRAM DESCRIPTIONS

Conservatorships

A Conservatorship is a civil legal process which begins with a referral to the PAGC from a variety of sources such as: hospitals, skilled nursing facilities, jails, the Superior Court and County agencies such as Adult Protective Services. In accordance with the Probate Code and Welfare and Institutions Code, the referral must include information about the physical or mental impairment that results in the individual’s inability to provide for their own personal needs such as health, food, clothing, shelter and financial management. Information is also required related to the client’s support system, such as family or friends and their ability or willingness to assist the individual. Finally, a conservatorship requires medical information including diagnosis, history and treatment and may require a mental capacity determination by a qualified specialist.

Once the referral is received by the PAGC, it is screened to ensure that the referral meets the guidelines as defined in the Probate Code and/or Welfare and Institution Code. If a referral meets the legal criteria, it is assigned to a Deputy Public Guardian Conservator (DPGC) who makes contact with the referring party and the individual and conducts an assessment and investigation to determine if there is a need for a conservatorship. If the client has assets, such as real and personal property, an Estate Administrator (EA) is also assigned to the

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case, and the DPGC and the EA work on the case conjointly. Estate Property Specialist staff may also assist with the inventory process and management of personal property. A crucial part of the investigation is to determine if there could be an alternate plan before assigning public conservatorship. This is accomplished by contacting health care providers, family and friends and/or helping to secure community based services. In some situations, there are family and friends who, despite their willingness to help, are not good conservator candidates. These people may be suspected of elder or dependent adult abuse and/or neglect of the client or they may have mental or physical limitations that make them unable to care for the conservatee.

If no alternate plan can be created to address the unmet needs of the individual referred, the PAGC staff completes the investigation and the PAGC asks County Counsel to petition the Superior Court for appointment of the PAGC as conservator. In some cases the Superior Court assigns an independent Court Investigator to assess the client and their needs, and determine the appropriateness of the petition for conservatorship. The Court Investigator then submits a recommendation to the Court. A hearing date is set and the individual referred is represented by the Public Defender or private counsel as needed. There are two types of conservatorships in PAGC: Lanterman Petris Short and Probate.

Lanterman Petris Short Conservatorship

A Lanterman Petris Short (LPS) Conservatorship is named for the three California legislators who wrote the LPS Act in 1967: Lanterman, Petris, and Short. This type of conservatorship may be appointed for individuals who are diagnosed with a serious mental illness and are determined to be either a danger to self/others or gravely disabled.

The LPS process is mandated by the California Welfare and Institution Code section beginning with 5000. The purpose is to arrange for the involuntary hospitalization and mental health treatment of individuals who meet the legal definition of danger to self/others or gravely disabled as a result of a mental health disorder and who are unwilling or unable to accept mental health treatment. An individual is referred to the PAGC for an LPS conservatorship when a psychiatric hospitalization, assessment, and treatment has determined a conservatorship is necessary. The request for a LPS conservatorship must come from a professional in charge of the local mental health facility, the local mental health director or the attending psychiatrist.

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During an LPS conservatorship, some individual rights such as having an active driver’s license and owning a gun may be revoked. After the acute psychiatric hospitalization, an individual may be placed in a locked psychiatric facility to receive ongoing treatment and support. The goal is to help the client manage their symptoms and treatment independently. The California Welfare and Institution Code mandates least restrictive placement, prompt evaluation and treatment, and safeguards the individual rights through the California Superior Court, probate division. The individual has the right to free legal representation from the Public Defender’s office and can attend court and request a hearing to contest a conservatorship.

Probate Conservatorship

A Probate Conservatorship may be appointed for individuals who experience significant impairments in cognitive function, which are due to dementia or other cognitive issues, and who may also be victims of elder or dependent adult abuse or neglect. Medical documentation by a qualified physician, psychologist or religious healing practitioner is required, specifying cognitive impairment and/or the client’s inability to provide for their own physical health, food, clothing, shelter, etc. In addition, the specialist will evaluate the client’s ability to manage their financial resources or resist fraud and undue influence.

The referral must also include documentation that there is no family, friend or support system that is willing or able to act on behalf of the individual. It must also indicate whether the individual has the ability to make medical or financial decisions for them.

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The PAGC receives referrals for probate conservatorship from a hospital, skilled nursing facility, a community or government agency such as Adult Protective Services. However, a petition for conservatorship can also be filed in Superior Court by private citizens on behalf of their own family members, companions or friends, without PAGC involvement.

• The California Probate Code 2920 mandates two situations where the PAGC must petition the Court to become probate conservator, if there is no one else to act:

• The Public Guardian shall apply for appointment as guardian or conservator of the person and/or estate, if there is an imminent threat to the person’s health, safety or estate.

• The Public Guardian shall apply for appointment as guardian or conservator of the person, the estate, or both if the Court so orders.

• In Probate, as in LPS conservatorships, some individual rights such as having an active driver’s license and owning a gun may be revoked. The individual has the right to free legal representation from the Public Defender’s office, to attend court and request a hearing to contest a conservatorship.

• The Superior Court may also appoint the PAGC in cases where the client is conserved under both LPS and Probate criteria. These cases are referred to as “Combo” cases and may also have an Estate Administrator assigned.

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Total Active Cases by Program Type

Total Cases by Program Type and Status

AsofOctober31,2017,therewereatotalof1,400activecases.

BetweenNovember2016andOctober2017,PAGCmanagedatotalof1,907cases.

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Referrals by Program Type

Ethnicity by Program Type

Age by Program Type

LPS PA Probate

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The Estate Administration (EA) unit manages and maintains the real and personal property of individuals for whom the PAGC has been appointed as the LPS or Probate conservator. EA staff members secure bank accounts and other monetary assets to ensure their use on behalf of the client. The EAs administer trusts, insurance policies, securities, annuities and other client assets. They look for and examine wills and documents to decipher the client’s wishes. Documents related to taxes and accountings are prepared and submitted to the SSA’s Financial Management Services (FMS) unit. An Estate Administrator may also, as part of an investigation of elder and dependent adult abuse, examine records and documents, as well as interview witnesses, to determine the fiscal history and economic circumstances of the conservatee. In cases where the PAGC intends to file for conservatorship and where financial abuse appears eminent, Probate Code 2901 allows the EA or DPGC to restrain anyone from transferring, encumbering, or disposing of the client’s real or personal property. This written certification protects assets and helps to prevent financial abuse.

Estate Administration

Asset Inventory by Type and Value

The Public Administrator (PA) is mandated by the California Probate Code to administer and provide estate closure services on behalf of deceased Santa Clara County residents when no one else is willing or able to execute the estate. California probate 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 to the Public Administrator division in the PAGC office. If the deceased relatives are not United States citizens, the PA is charged with closing the estate and assisting families with burial preparations and final interment.

Referrals come from funeral directors, law enforcement, the Court, the community, or coroner’s office. Once a referral is received, the PA initiates an investigation, which includes securing the decedents’ home,

Public Administration

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identification of financial resources, locating wills, trust documents, and heirs to the estate. If a will is found, the PAGC notifies the named executor. If a will and/or heirs are not found or the heirs are unable or unwilling to act, the PAGC has the responsibility to make funeral arrangements as well as to take prompt control of the property and assets that are subject to loss, injury, waste or misappropriation.

Probate Code determines the process of settling a decedent estate and is monitored by the Superior Court. It includes the collection and valuing of assets, notification of creditors, determination of debts and liabilities, filing and payments of inheritances, final income tax preparation and selling assets, as appropriate.

For the past couple of years, the PA unit did not have a full staff and extra help was used to attempt to close cases which lingered in the office, because of a variety of difficult circumstances like properties in foreign countries, complex shares in businesses, uncooperative potential heirs, etc. Regular meetings are now being held to address cases that are over three years old and to put in place systems that will move cases forward.

Court Accountings and Fee Collection

The Probate Code authorizes the PAGC to collect fees when client resources are available to do so in the Conservatorship and Public Administration programs. New fees not authorized by Probate Code are subject to Board approval. Fees are collected through the Court Accounting process and generated number needed in calendar year 2017. There are many fee categories, such as ordinary fees, bond fees, County Counsel fees, and extraordinary fees. These resources go directly into the General Fund to offset the cost of the PAGC program to county taxpayers.

In conservatorship cases, the PAGC must file an inventory with the Court listing all assets of a conservatee. According to the guidelines of the Probate Court, the accounting must be filed after the first year of conservatorship and every two years thereafter.

The Court Accounting lists all known property and its value, and financial activity including assets, income, liabilities, and property sold. At the time the accounting is presented to the Court, payment of requested fees is approved, if the Court deems appropriate. Once the Court has approved the collection of fees, the PAGC determines if a conservatee has the ability to pay. If fee payment causes impoverishment or presents a living expense hardship, the PAGC will defer the fee.

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In Decedent Estate cases, the Probate Code also provides a statutory framework for the collection of fees. The fees are based on the value of the estate and may include extraordinary fees. The collection of fees to the PAGC and statutory fees to County Counsel take priority over distributions to heirs or beneficiaries.

Note: “All Other Fees” in the chart below includes Public Defender Fees, LPS Investigative Fees, andExtraordinaryFeesforDPG,EA,EAAandEPT,etc.

Fees collected in 2016, by type

Total General Fund contribution: $1,752,883.62 (includes fees paid to County Counsel and the Public Defender’s Office)

Urgent Needs Fund

The Urgent Needs Fund (UNF) is intended to assist in the event of an emergency or urgent situation when no other funding source is immediately available for a conservatee or decedent estate. Emergency or urgent situations are unexpected events that have a significant impact and/or pose a threat to the person’s health, safety or welfare. The UNF addresses imminent needs that require payment within a week and is not intended to be ongoing financial support. The expectation is that the fund will be paid back with client funds in the future. No large withdrawals are made without a plan for reimbursement.

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The UNF was increased in October 2016, from $80,000 to $100,000. The additional funds provided more conservatees with emergency funds in urgent situations. This year the PAGC has seen a drastic increase in the cost of care for our clients. For example, 24/7 in-home care was a maximum of $9,000-$10,000 per month a year ago and now it is not uncommon to see $15,000 a month. This alarming jump in home care and a corresponding increase in the cost of assisted care in facilities, has necessitated large requests for advances from the Urgent Needs Fund, until assets are marshalled and/or reverse mortgages or sell of the home is accomplished. To exacerbate the situation, banks and financial institutions are reluctant to recognize the PAGC’s authority and providing requested documentation and waiting for approval can take months. Even with these large requests and the bureaucracy encountered, monitoring by PAGC management has resulted in positive aid to clients and no uncollectable debts.

In FY 2015, the Board of Supervisors replenished the UNF fund in the amount of $22,485.69 to reconcile past debts accumulated over years when regular managing and scrutiny were lacking. This year in its August 10 Annual Urgent Needs Fund Report to the Finance Government Operations Committee (FGOC), the PAGC reported no negative impact to the County General Fund and no need to replenish the fund. The PAGC in partnership with SSA’s Finance Management Systems (FMS) has designed a system that is beneficial to our clients and fiscally responsible.

Eligible requests to utilize the Urgent Needs Fund include, but are not limited to:

• Clothing • Food • Healthcare • Personal Care • Essential Housekeeping • Urgent Transportation • Emergency Shelter • Delinquent rent or mortgage payments • Delinquent caregiver payments • Home insurance • Property taxes • Home Owners Association Fees• Delinquent utility payments • Emergency or urgent medical needs not covered by other funding sources • Maintaining quality of life while waiting for funds to be available (including personal needs money)

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The Santa Clara County Superior Court appoints and holds the PAGC accountable to act on behalf of individuals and/or estates.

SSA Office of County Counsel represents the PAGC in conservatorship and public administration hearings and legal matters.

SSA Financial Management Services facilitates financial activity including payment of fees, distributions, accountings and taxes.

SSA Information Systems provides support for Panoramic and for key performance indicator reports.

Oversight of PAGC