San Mateo County Grand Jury
• 2004-2005
Issue | Background | Findings | Conclusions | Recommendations | Responses | Attachments Adult Protective Services and
⚠️ Translation Notice: This content has been automatically translated. The original English text is the official version. Translation may contain errors.
⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
Findings and Recommendations 2 findings
F1
Page 7
The Grand Jury recommends that the Board of Supervisors direct the Director of Health Services to: 1.1 identify the office of Public Guardian in its building and in directories to improve citizen awareness and access. 1.2 give proposed conservatees an explanation in person and in writing of their rights at the time of filing a petition to curtail or remove their personal and/or property rights. 1.3 issue specific written policies instructing the deputy Public Guardians about AAS priorities, including maintaining the conservatees in their own home if possible, locating and consulting with all family, friends, and neighbors (against whom there is no evidence of abusive actions), and providing all needed assistance without delay. 1.4 install a plan for regular agency oversight and consultation with the deputy Public Guardians. 1.5 eliminate any lag time between the time that all bank accounts are frozen and the time when provision is made for the proposed conservatee’s bills to be paid and supplies and services made available. 1.6 document the oversight and upgrade the training of in-home service caregivers. 1.7 establish written policies for requests for proposals or contracts for in-home caregiver organizations, financial managers, real estate brokers, et al. 1.8 visit conservatees living independently once a month at a minimum. 7 1.9 perform an annual audit of investment accounts of conservatees held by the Financial Manager to assure they are appropriately invested to meet the account goals and to clearly show the annual rate of return and commissions on transactions. 1.10 establish additional procedures that set rigorous “best practices” standards for calculation of fees and consider requiring that any billing method used not include cash or money market accounts as part of the total investment account, and determine whether there is additional compensation, such as commissions or partial commissions paid the Financial Manager as a result of his affiliation with the broker.
Related Recommendations (1)
R1
The Grand Jury recommends that the Board of Supervisors direct the Director of Health Services to: 1.1 identify the office of Public Guardian in its building and in directories to improve citizen awareness and access. 1.2 give proposed conservatees an explanation in person and in writing of their rights at the time of filing a petition to curtail or remove their personal and/or property rights. 1.3 issue specific written policies instructing the deputy Public Guardians about AAS priorities, including maintaining the conservatees in their own home if possible, locating and consulting with all family, friends, and neighbors (against whom there is no evidence of abusive actions), and providing all needed assistance without delay. 1.4 install a plan for regular agency oversight and consultation with the deputy Public Guardians. 1.5 eliminate any lag time between the time that all bank accounts are frozen and the time when provision is made for the proposed conservatee’s bills to be paid and supplies and services made available. 1.6 document the oversight and upgrade the training of in-home service caregivers. 1.7 establish written policies for requests for proposals or contracts for in-home caregiver organizations, financial managers, real estate brokers, et al. 1.8 visit conservatees living independently once a month at a minimum. 7 1.9 perform an annual audit of investment accounts of conservatees held by the Financial Manager to assure they are appropriately invested to meet the account goals and to clearly show the annual rate of return and commissions on transactions. 1.10 establish additional procedures that set rigorous “best practices” standards for calculation of fees and consider requiring that any billing method used not include cash or money market accounts as part of the total investment account, and determine whether there is additional compensation, such as commissions or partial commissions paid the Financial Manager as a result of his affiliation with the broker.
F2
The Grand Jury recommends that the Board of Supervisors fund Aging and Adult Services for additional transportation services for conservatees’ appointments for personal or medical care, or court appearances. Response: Disagree. AAS has one Transportation Officer who provides transportation for Public Guardian clients to Court, medical appointments, and for shopping. When Deputy Public Guardians transport conservatees to medical appointments, this time spent allows for conferring with medical treatment care providers and for individual visiting time with the conservatees. This is valuable and necessary time spent developing relationships and assuring that necessary services are appropriately provided. AAS will review current staff resources and allocations of funding for this function. Staff will convene a committee comprised of the Paratransit Council, Mental Health Services, and other community providers to address the overall transportation gaps and client needs, and will report back to the Board in January during the FY 2005-06 mid-year budget review.
Related Recommendations (1)
R2
The Grand Jury recommends that the Board of Supervisors fund Adult and Aging Services for additional transportation services for conservatees’ appointments for personal or medical care, or court appearances. 8
Conclusions 1
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CL1 Page 6The Grand Jury concluded that the APS and Public Guardian programs are adequately protecting the aged and dependent adults in our community but there are areas where improvement is needed. The Public Guardian’s office is not readily identifiable by the public, as the name and address are not found in the city and county directory, or at the office location. More contact with other California county Public Guardian offices could serve to facilitate communication, collaboration, and networking that would offer a higher level of service to conservatees, particularly since some clients may be placed out of the county. There is a need for increased effectiveness in locating families of conservatees and insuring that relatives are adequately informed and have the opportunity to assist. Care should be given to assure that the proposed conservatees understand, to the best of their ability, their rights when facing a conservatorship in ample time to exercise them. Conservatees living independently would benefit from a visit from the Public Guardian’s office once a month at a minimum. Written policy manuals for deputy public guardians are needed to provide directions for maintaining conservatees in their homes, dealing with family members, friends, and neighbors, detecting abuse, and providing prompt, needed assistance. There should be oversight of deputy public guardians to assure consistent and proper administration of agency policy. There is no oversight by the Public Guardian staff of in-home service caregivers. Those caregivers who work for the AAS in-home services need not be credentialed and training is minimal. Oversight is essential in all cases. 6 There should be no time lapse between freezing of bank accounts and the provision of assistance. The proposed conservatee should be left with some cash and whatever personal property can be safely left, in order that he or she feels comfortable, secure, and oriented to familiar surroundings. Caregiver help should be supplied immediately if needed. If medical prescriptions are ordered and sent to the Public Guardian, that office should deliver the medicine to the proposed conservatee promptly, rather than a week later as claimed by the complainant. The investment accounts of conservatees, held by the Financial Manager, need to be audited annually to determine the appropriateness of investments, to define the period covered by “average annualized rate of return,” and monitor the methodology used for fee and rate of return calculations. Consideration should be given as to whether cash and money market holdings should be included in the total estate value for purposes of the full fee calculation. The auditor should determine whether compensation exceeds the contract fee of 1% per year of the investment portfolio value, e.g. includes commissions or partial commissions or some other benefit as a result of the affiliation between the Financial Manager and the broker.
No Responses Found 1
Government entities assigned to respond to this report. No response documents have been linked in our database.
San Mateo County Board of Supervisors
Elected County Office