Sweeping Changes in Elder Care Pass

SACRAMENTO —  Responding to wrenching reports of elder abuse and neglect, the state Legislature on Wednesday overwhelmingly approved the most far-reaching changes to California’s conservatorship system in nearly three decades.

Lawmakers endorsed a package of reforms that would require licensing of professional conservators, who care for the state’s most vulnerable adults. It would also require greater supervision of their work by probate courts.

Advocates for the elderly hailed passage of the four-bill package as an important first step in restoring public trust after scandals in recent years showed how easy it was for professional conservators to victimize their elderly and infirm clients. Some advocates said they hoped that it would prompt similar changes around the country.

The push for reform was triggered by a Times series in November that described how some professional conservators were able to swiftly gain control over the lives and finances of elderly adults without their knowledge or consent, then neglect their wards, isolate them from relatives and run up fees.

“We all face this terrible, terrible risk of abuse,” said Assemblyman Dave Jones (D-Sacramento), who wrote one of the bills. “Ordinary Californians have had some experience or heard of people that have had bad experiences in the system, and they know that we need to reform it.”

The Legislature gave final approval to one of the bills Wednesday night. The other three each face one more vote by the end of today, which Jones and other lawmakers described as pro forma.

Then, the fate of the reform effort will be in the hands of Gov. Arnold Schwarzenegger, who has pledged support for improving the state’s conservatorship system but has yet to say whether he would sign any of the bills.

A Schwarzenegger spokeswoman said his office was still analyzing the final versions of the bills after weeks of talks with the authors.

“We are pleased with the progress that we’re making,” Sabrina Lockhart said. “The governor’s office has been engaged working with the legislators to provide the much-needed protections for ... the most vulnerable in our society.”

Schwarzenegger has until Sept. 30 to take action. If he signs the bills, California would become the sixth state to license or certify professional conservators, after Arizona, Washington, Florida, Alaska and Nevada.

Conservators control the care and finances of adults, usually elderly, who have been deemed by probate courts to be incapable of caring for themselves or managing their own finances. They were first envisioned as a way for relatives to help frail, failing family members.

But conservatorship has become a growing business as the population has aged and families have dispersed, leaving some seniors with no one to care for them. In California, about 500 professional conservators look after 4,000 clients, overseeing $1.5 billion in assets.

Despite the well-publicized scandals involving theft from seniors under conservatorship, previous proposals to license and regulate professional conservators repeatedly foundered in Sacramento amid concerns about costs and big government.

The Times’ investigation found that the probate courts often performed their oversight duties poorly. In some counties, court investigators were so overwhelmed with cases that they were years behind in visiting and interviewing adults under conservatorship, as required. Meanwhile, the courts overlooked incompetence, neglect and outright theft by conservators.

California Chief Justice Ronald M. George lauded passage of the bills and said reforms were urgently needed.

At a news conference, Jones and other lawmakers were joined by Geri Brown, a state parole officer whose elderly mother was placed under the care of a professional conservator without permission from either Brown or her mother. The Times’ series reported how Brown had to hire an attorney to fight off the conservator, a process that cost her family $30,000 and made the months before her mother’s death particularly painful.

“It feels like you’ve really given us a voice that wasn’t there before,” Brown told lawmakers. “I forewarn everyone I know: This could happen to each and every one of you.”

Jones’ bill would bolster court oversight of all conservators, not just professionals. The legislation would give courts the ability to audit the financial reports of conservators and would increase the frequency with which court investigators must visit people under conservatorship.

Jones’ proposal would also make it harder for conservators to gain control of the lives and finances of the elderly on an emergency basis, often without their knowledge, by saying that they are in imminent danger. Court investigators would have to visit adults before -- or within two days of -- an emergency appointment.

This year’s state budget contains no money for the courts to meet the new requirements, which would cost an estimated $8.7 million a year. The bill would go into effect July 2007.

Jones’ measure would also require public guardians, county officials whose offices operate as conservators of last resort, to intervene when there is an imminent threat to the person’s health or the safety of their estate. The Times found that Los Angeles County’s public guardian turned away four of every five people referred to it. It often took months to act, and hundreds of seniors died while on its waiting list.

To resolve cost concerns, Jones dropped proposals to create an ombudsman to review complaints about conservators and to create self-help centers in the courts for relatives and friends acting as conservators.

Patricia McGinnis, executive director of California Advocates for Nursing Home Reform, said she was disappointed by the amendments but called the reforms a considerable improvement over the current system.

“It’s going to open the system up,” McGinnis said. “It’s finally going to have some sunshine on it.”

Two other bills also won approval. One, written by Sen. Jack Scott (D-Altadena) would make it more difficult for conservators to move wards out of their homes and sell the property. The other, by Sen. Debra Bowen (D-Marina del Rey), would allow courts to investigate complaints about conservators made informally rather than having to wait for a legal filing in order to act.

If signed by the governor, the licensing legislation would mark the most significant change in the way the state’s professional conservators are regulated since the first entrepreneur opened up business more than a quarter century ago.

Under the current system, anyone objecting to abuse or neglect by a conservator must hire an attorney and file formal paperwork with the courts, an expensive and lengthy process.

“I think that now they will have a place to go,” said Sen. Liz Figueroa (D-Fremont), who wrote the bill. “Where before they felt that there was no transparency, no accountability and no oversight, now with our pieces of legislation they will feel that they have all three.”

The governor’s office had objected to Figueroa’s original proposal of an independent licensing board, preferring a bureau run by civil servants accountable to the governor. In recent days, Figueroa altered her bill to include a bureau.

Conservators themselves hailed the vote as a breakthrough they had long sought to legitimize their business and ensure that practitioners are adequately trained.

“Like any profession, there need to be standards,” said Shirley Trissler, former president of the Professional Fiduciary Assn. of California. “We’re very happy it’s finally happening.”

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(BEGIN TEXT OF INFOBOX)

Q&A;

Question: Why do supporters say this legislation was needed?

Answer: They cited reports that conservators had stolen from their wards, neglected them, isolated them from loved ones and run up fees. The Times published a series in November highlighting some of these cases. Lawmakers said subsequent hearings by the Assembly and Senate confirmed the newspaper’s findings.

Q: What does the legislation do?

A: The reform package of four bills requires licensing of professional conservators and intensified court oversight of all conservators, particularly by court investigators who visit wards to check on their welfare. In addition, public guardian offices must seek conservatorship in cases where people face an imminent threat to their health or the safety of their estate.

Q: What happens next?

A: The bills go to Gov. Arnold Schwarzenegger, who has until Sept. 30 to sign or veto them. Schwarzenegger’s office has voiced support for reforming the conservatorship system but has not said whether he will sign the bills. He must sign all four bills for them to take effect.

Q: Are there critics of this reform package?

A: Yes. The state courts and some counties have raised concerns about lack of funding for the initiatives. Some Republican lawmakers object to the costs of the reform and question the need for a new licensing bureaucracy. Though most elder rights advocates support the legislation, some believe the package should have added more protections.

Los Angeles Times