August 31, 2017 Guardianship Audit Update
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- Julius Charles
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1 August 31, 2017 Guardianship Audit Update Florida Court Clerks & Comptrollers 2018 Winter Conference
2 Anthony Palmieri Deputy Inspector General and Chief Guardianship Investigator Clerk & Comptroller, Palm Beach County Administrative Coordinator Clerks Statewide Investigations Alliance
3 Clerk s Role in Florida Guardianship System Oversight Courts OPPG Auditing/Reviewing Investigating Clerk
4 Clerk s Role in Florida Guardianship System Independent check and balance Levels the playing field Solutions driven Experts Ensures integrity Warms the bench
5 Clerk s Role with Florida WINGS
6 Florida Supreme Court/OSCA JMC WINGS Steering Committee WINGS Stakeholders
7 WINGS Vision Statement The vision of Florida WINGS is to serve the best interests of those needing decision making assistance in order to promote their well being, dignity, and independence.
8 WINGS Mission Statement Florida WINGS is a collaborative group of stakeholders dedicated to creating solutions through court community partnerships by identifying, assessing and improving guardianship practices and decision making alternatives to enhance the quality of care and lives of vulnerable adults.
9 WINGS Survey 307 total responses Attorney/Legal Staff 122 Family/Friends 54 Professional Guardians 39 Family Guardian 27 Public Guardians 10 Persons Under Guardianship 2 Clerks 2 Law Enforcement 1
10 WINGS Survey by county Miami-Dade 63 Broward 52 Palm Beach 40 Hillsborough 28 Pinellas 27 Orange 26 Brevard 23 Lee 21 Sarasota 20
11 Requires additional training Assisted Living Facilities 93 Caregivers 82 Law enforcement 61 Attorneys 56 Judges 47 Professional Guardians 47 Clerks 46 Court staff 41
12 WINGS Survey Comments It must be abolished Get guardianship out of the courts and away from the good ole boys It s modern day slavery and human ownership Stop jamming system to garner fees for connected cohorts of stakeholders
13 WINGS Survey Court and Clerk systems need to be more efficient It takes to long and it is too expensive More training to gatekeepers Better funding for training of judges and clerks Where exactly in the clerk office do my court filed documents go after filing?
14 Opinion of Florida Guardianship System Answered fair to very good 72.4 % Less than fair to poor 24.4 %
15 Clerk s Role with Auditing
16 Florida Constitution Article V, Section 16 Section , Fla. Stat.: Clerk shall audit the reports & advise the court.
17 Finder of fact vs. trier of fact Assisting with administration of proceedings Systematic review Verifications, reviews of substantiating papers Interviews, inspections, & investigations
18 Court Waiving Verified Initial Inventory Annual Accounting Clerk s audit Guardian Education Training (4 & 8 hour) Attorney of Record
19 Ex Parte Communication Done for one party only No notice or contestation By person adversely interested
20 Permissible Ex Parte Communication Authorized by law For scheduling and administrative purposes Not substantive matters or issues on the merits Disinterested expert advise on the law applicable If notice and reasonable opportunity to respond
21 Florida Code of Judicial Conduct Perform duties without bias or prejudice Right to be heard according to the law Dispose all matters fairly
22 Clerk s Role with Life Insurance Proceeds
23
24 Clerk s Role with Guardian Fees
25 Guardian s registration requirements Section , Fla. Stat.: Reasonable fee for services to or on behalf OPPG Standards of Practice 58M (22): Reasonable fees & related to guardianship duties
26 Clerk s Role with Attorney Fees
27 Guardianship Attorney Fees Section , Fla. Stat.: Fees submitted to the court Must have itemized description of services
28 Other Attorney Fees Section , Fla. Stat.: Employ & pay reasonable fees Tax attorney Criminal defense attorney Personal injury attorney
29 Clerk s Role with Trusts
30 Initial Verified Inventory Section , Fla. Stat.: Must include trusts when ward is beneficiary
31 Annual Accounting Section , Fla. Stat.: All of the ward s property Guardian has control Does not apply to trust which ward is beneficiary but not under the control or administration of guardian
32 Annual Accounting Section , Fla. Stat.: All of the ward s property Guardian has control Does not apply to trust which ward is beneficiary but not under the control or administration of guardian
33 Clerk s Role with Auditing Trusts (2)(a) Guardian=Trustee (19) Court Ordered Trust Pre- Guardianship Trust
34 Clerk s Role with Attorney/Professional Guardians
35 Definition of Professional Guardian Section (17), Fla. Stat.: Means any guardian Rendered guardian services 3 or more non-relative wards
36 Registration with the OPPG Section (1), Fla. Stat.: A professional guardian must register with the OPPG.
37 Consideration for Appointment Section (9), Fla. Stat.: The court may not appoint any professional guardian who is not registered
38 Clerk s Role with Medical Reports
39 Section , Fla. Stat.: Clerk shall review guardianship plans Ensure plan contains information
40 Guardianship Plan Section , Fla. Stat.: Includes physician s report Who examined the ward
41 Definition of Physician Section , Fla. Stat.: Person who is licensed to practice medicine Diagnosis, treatment, operation, or prescription For human disease, pain, injury, deformation Or other physical or mental condition
42 Title Can They Complete & Sign Off on Physical Reason Authority Medical Doctor (MD) Yes Able to diagnose s Doctor of Osteopathy (DO) Yes Able to diagnose s Physician Assistants Yes Is licensed to perform medical services and diagnose Advanced Registered Nurse Practitioner (ARNP) Who can perform physicals? s (2)(e); FAC 64B and 64B Yes Given explicit authority to diagnose s (3) and (20); s (3); FAC 64B and 64B Clinical Nurse Specialist (CNS) Yes Given explicit authority to diagnose s (6), (7) and (20); FAC 64B Psychiatrists Yes Psychiatrists are able to diagnose and treat mental, nervous, psychological, marital, or emotional disorders, illnesses, or disability, alcoholism and substance abuse, and disorders of habit or conduct, as well as psychological aspects of physical illness, accident, injury, or disability, including neuropsychological evaluation, diagnosis, prognosis, etiology, and treatment. Chiropractic Physician Yes Diagnosis medical conditions is not listed under the definition of the practice of chiropractic medicine. However, in section e it states that they can analyze and diagnose the physical conditions of the s (4) s (9)(a) & (e)
43 Title Who can perform physicals? Can They Complete & Sign Off on Physical Reason Authority Athletic Trainer No Can treat athletic injuries but no authority to do complete physical examination and make a diagnosis s & s ; FAC 64B Certified Chiropractic Physician s Assistant No May perform physical exams nut also they function in a dependent relationship with a supervising physician. They cannot render diagnostic results or interpretations or render treatment advise unless properly certified. Physician must sign off on the physical. s ; FAC 64B (5) Registered Chiropractic Assistant No May only assist with patient care management and administrative and clinical procedures. Not able to diagnose. s ; FAC 64B (6) Acupuncturist No Acupuncturist may not diagnose medical conditions outside of the need for acupuncture. s (1); s ; FAC 64B Licenses Practical Nurse (LPN) No No authority to perform diagnosis s (16) and (19); s (5); FAC 64B Medical Assistant No Not able to perform diagnoses s Registered Nurse (RN) No Practices professional nursing; can perform assessments and nursing diagnosis s (20) and (22); FAC 64B Certified Nursing Assistant (CNA) No No authority to perform diagnosis s (5); FAC 64B
44 Clerk s Role with Criminalization of Guardianship Fraud
45 Bridging the Gap between civil guardianship & criminal justice system First responders DCF/APS
46 Indirect Criminal Contempt Rules of Criminal Procedure 3.840: Order to Show Cause Order of Arrest Arraignment
47 Investigation Costs Section , Fla. Stat.: Convicted persons are liable for investigative costs for law enforcement agencies If requested by such agencies Determination of guilt by trial or plea
48 Clerk s Role with Statewide Investigations www. FLClerkSIA.com
49
50 Clerks Statewide Investigations Section , Fla. Stat.: State required to investigate Any complaint Professional guardian Violated standards of practice www. FLClerkSIA.com
51 OPPG Complaints Stealing ward s property Isolating of ward, unnecessarily restrictions Not communicating Colluding, racketeering, corruption Conflicts of interest, self-dealing Breaching fiduciary duties Inadequate care, not considering ward s wishes Decisions not in best interest of ward www. FLClerkSIA.com
52 Illicit Motives for Complaint Retaliation Vindictiveness Jealousy Greed Smoke screen/diversion Delusions / fictitious www. FLClerkSIA.com
53 Finds of Fact Substantiated means there is sufficient information to justify a reasonable conclusion that the allegation is true. Unsubstantiated means there is insufficient information to either prove or disprove the allegation. Unfounded means there is sufficient information to indicate the allegation is false. www. FLClerkSIA.com
54 Reporting Criminal Law Enforcement Administrative OPPG Civil Court/Clerk www. FLClerkSIA.com
55 Statistics 110 Complaints forwarded to Clerks IG Pinellas Co. (12) Seminole Co. (11) Broward Co. (8) Palm Beach Co. (8) Miami-Dade Co. (8) Brevard Co. (7) Hillsborough Co. (6) Orange Co. (6) October 1, 2016-March 1, 2018 www. FLClerkSIA.com
56 Statistics Tampa Bay 2.6 million population 22 cases I-4 Corridor 4.2 million population 29 cases South Florida 6 million population 29 cases www. FLClerkSIA.com October 1, 2016-March 1, 2018
57 Statistics 273 Allegations Investigated Substantiated (29) Unsubstantiated (40) Unfounded (159) 9 Additional Observations 45 Determined to be Non-Legally Sufficient 136 Investigative Memos & Reports Issued October 1, 2016-March 1, 2018 www. FLClerkSIA.com
58 Statistics 136 Investigative Memos & Reports Issued 40 Investigations Closed 13 Complaints Non-Legally Sufficient October 1, 2016-October 7, 2017 www. FLClerkSIA.com
59
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This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the Benefit Booklet at www.ucop.edu/ucship or by calling 1-866-940-8306. Important Questions
You don t have to meet deductibles for specific services.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2019-12/31/2019 Highmark Blue Shield: PPO Blue Coverage for: Individual/Family Plan Type:
Aetna Student Health: University of Southern California Coverage Period: beginning on or after 5/17/13
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at http://www.aetnastudenthealth.com/usc or by calling 1-877-626-2299.
limit. The chart starting on page 2 describes any limits on what the plan will pay for specific covered services, such as office visits.
White Earth Band of Chippewa Indians Coverage Period: Beginning on or after 10-01-16 Summary of Benefits and Coverage: What this Plan covers & What it Costs Coverage for: Single and family coverage Plan
Blue Care Elect Preferred The MathWorks - PPO Plan Coverage Period: on or after 01/01/2017
Blue Care Elect Preferred The MathWorks - PPO Plan Coverage Period: on or after 01/01/2017 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual and Family Plan
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.accesstpa.com or by calling 1-866-738-3924. Important
Assurant Health. Time Insurance Company. Summary of Benefits and Coverage for Assurant Health individual major medical Silver plans
Assurant Health Time Insurance Company Summary of Benefits and Coverage for Assurant Health individual major medical Silver plans View Summary of Benefits and Coverage for an individual plan View Summary
Aetna Open Access Managed Choice - PPO 2000/80
Important Questions Answers Why this Matters: What is the overall For each Calendar Year, In-network: You must pay all the costs up to the deductible amount before this plan deductible? Individual $2,000
IU Health Plans: IU Health Traditional PPO Medical Plan OOA Coverage Period: 01/01/ /31/2016 Summary of Benefits and Coverage:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.myiuhealthplans.com or by calling 1.800.873.2022. Important
You don t have to meet deductibles for specific services.
Summary of Benefits and Coverage: What this Plan Covers & What you pay for covered services Coverage Period: 01/01/2018-12/31/2018 Highmark West Virginia: my Connect Blue WV PPO 2800SQE Coverage for: Individual/Family
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.summacare.com or by calling 1-800-996-8701. Important
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.usciences.myahpcare.com or by calling 1-888-547-5080.
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.anthem.com or by calling 1-888-224-4902. Important Questions
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan
Coverage Period: 01/01/2016 12/31/2016 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual & Eligible Family Plan Type: PPO This is only a summary. If you want
Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services. Coverage Period: 1/1/ /31/2018
Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 1/1/2018 12/31/2018 County of Orange Wellwise Choice Coverage for: Individual + Family Plan
Regence BlueCross BlueShield of Oregon: Preferred Coverage Period: 01/01/ /31/2016
Regence BlueCross BlueShield of Oregon: Preferred Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 01/01/2016 12/31/2016 Coverage for: Individual & Eligible Family
Important Questions Answers Why this Matters: Network: $500 Individual $1,000 Family Non-Network: $1,500 Individual $3,000 Family
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.inhealthohio.org or by calling 1-800-580-8502. Important
You don t have to meet deductibles for specific services.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2018-12/31/2018 Highmark Blue Cross Blue Shield: my Priority Blue Flex HMO 6200BQE Coverage
HUMANA INSURANCE Humana National Preferred Silver 4250/6250 Plan Coverage Period: Beginning on or after 01/01/2014 Summary of Benefits and Coverage:
HUMANA INSURANCE Humana National Preferred Silver 4250/6250 Plan Coverage Period: Beginning on or after 01/01/2014 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for:
Highmark West Virginia: Shared Cost Blue PPO 2500 Coverage Period: 01/01/ /31/2015
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.highmarkbcbswv.com or by calling 1-888-601-2109. Important
Cummins Central Power, LLC Coverage Period: 05/01/ /30/2016
Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual/Family Plan Type: PPO What is the overall deductible? This is only a summary. If you want more detail about
Highmark Blue Cross Blue Shield: BLUECARE CUSTOM PPO EXP Coverage Period: 01/01/ /31/2017
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.highmarkbcbs.com or by calling 1-800-241-5704. Important