With advance planning there are some alternatives that can possibly prevent the need for conservatorship while also providing a smoother transition in the care of the disabled person and reducing the strain on loved ones. Planning ahead regarding both medical and financial decisions is critical. In some situations, a durable Power of Attorney, an advance health care directive, a living trust, or even a representative payee service may be sufficient. These alternatives can be put in place prior to a person becoming disabled, so please consult with qualified professionals while loved ones are still in good health. If a person is already disabled or otherwise incapable of assisting with the establishment of alternatives, a conservatorship may be necessary.

As mentioned above, the use of a payee service may be sufficient to provide for an individual’s needs. For persons receiving Social Security benefits, the Social Security Administration is encouraging the use of organizational or institutional payees. For more information see their website at http://www.socialsecurity.gov/payee

Serving as power of attorney, trustee, or representative payee provides significant authority in the management of another person’s financial affairs. With this authority also come responsibility and accountability. To help you better understand what serving in any of these capacities entails, the federal Consumer Financial Protection Bureau’s Office for Older Americans has prepared several guides on managing someone else’s money. These guides are similar, yet have some specific information and resources depending on the type of financial management provided. Please click on the role that applies to you: Trustee, Representative Payee/Fiduciary, or Power of Attorney.

The Public Guardian does not ordinarily file petitions for conservatorship of persons residing in nursing homes or hospitals unless the person is a victim of financial exploitation, another form of elder abuse, or family members are obstructing the person’s care and treatment. The Public Guardian is often asked about conservatorship for an individual in a facility because he or she is unable to make medical decisions, sign facility admission agreements, or needs assistance paying bills including their placement cost. A conservatorship is not necessary in these cases because alternatives exist to meet those needs.

In regard to medical needs, California Probate Code section 3200 et seq. provides an avenue to obtain authority to make medical decisions without a conservatorship. Any interested person, including a patient’s physician or treatment facility staff, may petition the court for authority. In addition, California Health and Safety Code section 1418.8 provides that an interdisciplinary team can oversee the medical care of a patient when the patient lacks capacity to give informed consent to treatment.

The inability to sign facility admission documents is also addressed by California law. California Welfare and Institutions Code section 14110.8(b) maintains no facility may require or solicit as a condition of admission into the facility that a Medi-Cal beneficiary have a responsible party sign or cosign the admissions agreement. In addition, California Health and Safety Code section 1599.65 clarifies in the event a patient is unable to sign a contract, the reason shall be documented in the resident’s medical record by the admitting physician.

A resident’s inability or refusal to pay placement costs can be addressed with the help of Social Security. In fact, the Social Security Administration encourages institutions, including skilled nursing facilities, to serve as representative payees and assist with payment of monthly placement costs. For more information, visit Social Security’s web page on representative payees. http://www.socialsecurity.gov/payee