BILL ANALYSIS Ó SENATE JUDICIARY COMMITTEE Senator Hannah-Beth Jackson, Chair 2015-2016 Regular Session AB 436 (Jones) Version: March 9, 2015 Hearing Date: June 16, 2015 Fiscal: No Urgency: No TMW SUBJECT Guardian or conservator: powers and duties DESCRIPTION This bill would require a court, upon granting or denying authority to a conservator for the placement of a conservatee in a residential care facility or administration of medications for the care and treatment of dementia, to discharge the court-appointed attorney or order the continuation of the legal representation of the conservatee. BACKGROUND In 1996, about 500,000 to 600,000 people in California suffered from Alzheimer's disease or stroke-related dementia, which placed them at risk for wandering away from unsecure residential facilities and becoming lost. At that time, many courts would not grant a conservator the authority to place a dementia patient in a secured facility, or to authorize administration of psychotropic medications, unless a conservatorship under the Lanterman-Petris-Short (LPS) Act was established, and renewed yearly. An LPS conservatorship, among other things, is designed to provide safeguards for persons who are deemed to be gravely disabled as the result of a mental disorder who may, for some period, require placement in a locked facility or administration of psychotropic drugs. The nature of these mental disorders is such that, with the administration of the drugs, the patient's condition may well improve. In such instances, the patient's AB 436 (Jones) Page 2 of ? status needs to be reviewed periodically. For this reason the LPS conservatorship is required to be renewed every year. Recognizing the need to allow a conservator to place a person with dementia in a more appropriate secured facility and authorize the administration of psychotropic medications which permit management of patients with dementia in non-secure facilities, the Legislature enacted SB 1481 (Mello, Chapter 910, Statutes of 1996) to authorize a conservator to file a petition to place a conservatee with dementia in an appropriate secured facility and authorized the administration of psychotropic medications, which permit management of patients with dementia in non-secure facilities. As part of that process, a conservatee has the same rights to petition the court to contest and terminate this authority as any other conservatee has to contest and terminate a conservatorship, and the conservatee must be represented by an attorney during that process. In order to clarify for both the courts and the court-appointed attorneys for conservatees, this bill would require a court, upon granting or denying authority to a conservator for the placement of a conservatee in a residential care facility or administration of medications for the care and treatment of dementia, to either discharge the court-appointed attorney or order the continuation of the legal representation of the conservatee. CHANGES TO EXISTING LAW Existing law authorizes a court to appoint a conservator to act on behalf of a person who is unable to adequately provide for his or her personal needs (a conservator of the person) or incapable of managing his or her property or other financial assets (a conservator of the estate). (Prob. Code Sec. 1800 et seq.) Existing law authorizes a proposed conservatee, or spouse, domestic partner, relative, friend of the conservatee, public administrator, or other interested person to petition the court for the appointment of a conservator of the proposed conservatee. Existing law requires specified information to be included in the petition. (Prob. Code Secs. 1820, 1821.) Existing law authorizes a court, upon a showing of good cause, AB 436 (Jones) Page 3 of ? to appoint a temporary conservator or guardian to serve pending the appointment of a permanent conservator or guardian. Unless the court orders otherwise, existing law provides the temporary conservator or guardian with only those powers and duties that are necessary to provide for temporary care of the conservatee or ward and to preserve and protect the property of the conservatee or ward from loss or injury. (Prob. Code Sec. 2250 et seq.) Existing law requires a court, when determining the capacity of a person to do a certain act or make a decision, including, but not limited to, making medical decisions, to make that determination based on evidence of a proposed conservatee's deficit in at least one of a specified list of mental functions. (Prob. Code Sec. 811(a).) Existing law authorizes the court to appoint private legal counsel for a conservatee or a proposed conservatee in any proceeding if the court determines the person is not otherwise represented by legal counsel and that the appointment would be helpful to the resolution of the matter or is necessary to protect the person's interests. (Prob. Code Sec. 1470(a).) Existing law , if a person is furnished legal counsel, requires the court, upon conclusion of the matter, to fix a reasonable sum for compensation and expenses of counsel, and the sum may, in the court's discretion, including compensation for services rendered, and expenses incurred, before the date of the order appointing counsel. (Prob. Code Sec. 1470(b).) Existing law provides that, if the conservatee requires medical treatment for an existing or continuing medical condition which is not otherwise authorized to be performed upon the conservatee, and the conservatee is unable to give an informed consent to this medical treatment, the conservator may petition the court for an order authorizing the medical treatment and authorizing the conservator to consent on behalf of the conservatee to the medical treatment. (Prob. Code Sec. 2357(b).) Existing law allows a conservator to authorize the placement of a conservatee in a secured perimeter residential care facility for the elderly (RCFE) upon a court's finding, by clear and convincing evidence, all of the following: (1) the conservatee has dementia, as defined; (2) the conservatee lacks the capacity to give informed consent to this placement and has at least one AB 436 (Jones) Page 4 of ? mental function deficit, and this deficit significantly impairs the person's ability to understand and appreciate the consequences of his or her actions; (3) the conservatee needs or would benefit from a restricted and secure environment, as demonstrated by evidence presented by the physician or psychologist, as specified; and (4) the court finds that the proposed placement in a locked facility is the least restrictive placement appropriate to the needs of the conservatee. (Prob. Code Sec. 2356.5(b).) Existing law allows a conservator of a person to authorize the administration of medications appropriate for the care and treatment of dementia, upon a court's finding, by clear and convincing evidence, of all of the following: (1) the conservatee has dementia, as defined; (2) the conservatee lacks the capacity to give informed consent to the administration of medications appropriate to the care of dementia, and has at least one mental function deficit, and this deficit or deficits significantly impairs the person's ability to understand and appreciate the consequences of his or her actions; and (3) the conservatee needs or would benefit from appropriate medication as demonstrated by evidence presented by the physician or psychologist. (Prob. Code Sec. 2356.5(c).) Existing law requires that the conservatee be represented by an attorney during proceedings for the conservator's petition for authority to act regarding facility placement or dementia medication administration. (Prob. Code Sec. 2356.5(f)(1).) This bill , upon granting or denying authority to a conservator to place the conservatee in a secured RCFE or administer dementia medications, would require the court to discharge the conservatee's attorney or order the continuation of the legal representation. COMMENT 1. Stated need for the bill The author writes: Absent a court order either directing them to continue or dismissing them, court-appointed attorneys (CAAs) in dementia powers cases are on the horns of an ethical and legal dilemma once the hearing has been held and powers granted or denied. AB 436 (Jones) Page 5 of ? Attorneys are concerned that if they do nothing, they could be subject to discipline for client abandonment or possibly malpractice. On the other hand, if they proceed as if they are still functioning as counsel - e.g., checking in on the client and/or preparing a report - their actions can be subject to resentment and challenge by the conservator and/or the family, contending that it was only done to generate fees for the attorney. Without greater clarity, the Courts must also speculate as to the legislative intent regarding the scope of the appointment, and whether it is to terminate at the end of the appointment hearing or continue for monitoring. This uncertainty may have fostered an assumption in some courts that they are continuing appointments, and in others that they are meant to terminate. AB 436 requires the court, after the petition seeking dementia powers is decided, to either discharge the attorney or order the continuation of such representation. The bill does not require such continuing representation, but gives the court the discretion to decide whether to require that counsel be retained. The bill does require that the decision about whether or not to continue the representation be based on the existing statutory constraint, which permits a court to appoint counsel if appointment either would be helpful in resolving matters or is necessary to protect the interest of the conservatee. 2. Clarifying termination or continuation of court-appointed attorney representation of a conservatee Although existing law authorizes a court to appoint an attorney to represent the interests of a conservatee in proceedings for the placement of the conservatee in a secured residential care facility for the elderly (RCFE) or the administration of dementia medications, the law does not specify when the attorney's representation of the conservatee ends. Accordingly, this bill seeks to provide clarification of when the court-appointed attorney's services ends or continues. Notably, following the granting of a petition to place the conservatee in a secured RCFE or administration of dementia medications to the conservatee, the court investigator is required to annually investigate and report to the court every two years. (Prob. Code Sec. 2356.5(g).) If the conservatee objects to the conservator's continued powers granted in that AB 436 (Jones) Page 6 of ? petition, or the investigator determines that some change in the powers granted in the petition proceeding is warranted, the court is required to provide a copy of the court investigator's report to the attorney of record for the conservatee. (Id.) If no attorney has been appointed for the conservatee, an attorney is required to be appointed and take several enumerated actions on behalf of the conservatee. (Id.) If an attorney was court-appointed during the initial petition, but has had no contact with the conservatee or court following the granting of the petition, the attorney may believe he or she is no longer providing services to the conservatee. Yet, under existing law, that attorney may be called upon at any time following the initial petition to continue representation of the conservatee. As such, courts, court-appointed attorneys, conservators, and conservatees may be uncertain as to when the court-appointed attorney continues to represent the conservatee, years after the initial petition, or no longer represents the conservatee after the initial petition. The Conference of California Bar Associations (CCBA), sponsor, notes that this bill is the result of a bench-bar working group in San Diego, in response to concerns raised by attorneys in the field and the uncertainty of the local judges regarding court-appointed attorney responsibilities. CCBA argues that "Absent a court order either directing them to continue or dismissing them, court-appointed attorneys . . . in dementia powers cases are confronted with an ethical and legal dilemma once the hearing has been held and powers granted or denied. If they do nothing, attorneys are concerned they could be subject to discipline for client abandonment or possibly malpractice. Conversely, if they proceed as if they are still functioning as counsel - e.g., checking in on the client and/or preparing a report - their actions can be subject to resentment and challenge by the conservator and/or the family, contending that it was only done to generate fees for the attorney." Accordingly, this bill seeks to provide clarification for the court and interested parties by giving discretion to the court to either discharge the attorney when dementia powers are granted, or direct the court-appointed counsel to continue to represent the conservatee's due process rights. 3. Opposition's concerns The Coalition for Elder and Dependent Adult Rights (CEDAR), opposed unless amended, argues that this bill would not solve AB 436 (Jones) Page 7 of ? the real problem that courts do not have written fee agreements with attorneys appointed by courts to represent conservatee interests. CEDAR requests that the bill be amended to instead require court-appointed attorneys to adhere to the written fee agreement requirements under the Business and Professions Code. In response, the author states that this bill addresses whether appointed counsel is relieved of further duties or has further obligations to the conservatee, which can only be answered after the court has made its decision regarding the conservator's dementia powers petition, and, therefore, cannot be reasonably included in the terms of a contract under the Business and Professions Code. Support : None Known Opposition : Coalition for Elder and Dependent Adult Rights HISTORY Source : Conference of California Bar Association Related Pending Legislation : None Known Prior Legislation : AB 2747 (Committee on Judiciary, Chapter 913, Statutes of 2014) among other things, corrected the cross-references to the relevant California Code of Regulations requirements in the petition for placement of a conservatee in a locked and secured nursing facilities which specializes in the care and treatment of people with dementia. AB 167 (Harman, Chapter 32, Statutes of 2003), among other things, corrected the cross-reference to findings of dementia under the petition for placement of a conservatee in a residential care facility for the elder or for the administration of medications for the care of dementia. AB 1172 (Kaloogian, Chapter 724, Statutes of 1997), among other things, authorized a licensed psychologist to report his or her findings of dementia in a declaration submitted with a conservator's petition for placement of a conservatee in a residential care facility for the elder or for the AB 436 (Jones) Page 8 of ? administration of medications for the care of dementia. SB 1481 (Mello, Chapter 910, Statutes of 1996) See Background. Prior Vote : Assembly Floor (Ayes 78, Noes 0) Assembly Judiciary Committee (Ayes 10, Noes 0) **************