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(CAPAPGPC Letterhead)February ___, 2021The Honorable Nancy SkinnerChair, Senate Budget CommitteeCalifornia State Senate, District 28State Capitol, Room 5080Sacramento, CA 95814The Honorable Susan Talamantes EggmanChair, Senate Budget and Fiscal Review Subcommittee #3State Capitol, Room 4052Sacramento, CA 95814The Honorable Phil Ting, AssemblymemberChair, Assembly Budget CommitteeCalifornia State Assembly, District 19State Capitol, Room 6026Sacramento, CA 95814The Honorable Joaquin Arambula, M.D. Chair, Assembly Budget Subcommittee #1 State Capitol, Room 5155 Sacramento, CA 95814Dear Honorable Members:The California Association of Public Administrators, Public Guardians, and Public Conservators (CA|PA|PG|PC) humbly requests your consideration of an ongoing General Fund appropriation of $120 million to ensure counties can respond appropriately to the growing population of some of the most vulnerable Californians – people who are unable to provide for their own basic needs or die without a person in their life to protect their property and assets after death.PA|PG|PC programs serve adults in every California county who are unable to act in their own best interests as a result of psychiatric disorder, cognitive impairment, or death. Through appointment by the local Superior Court, Public Conservators and Guardians become the legal decision maker for individuals’ psychiatric care or medical care, placement or housing, and financial matters. Public Administrators are appointed by the local Superior Court for individuals who die without wills or appropriate persons who can administer their estates. Public Guardians primarily assist individuals with Alzheimer’s disease, traumatic brain injuries, or other cognitive disorder that affect their ability to make decisions; Public Conservators assist persons with serious mental illness, such as schizophrenia, bipolar disorder, or depression, that affect their ability to make decisions.??For the past several years, PA|PG|PC programs have been operating at full capacity and are struggling to meet the needs of growing target populations in their communities. Currently, PA|PG|PC programs are short staffed by more than 50%, and target populations have grown approximately 30% in just the last 5 years. As reported in the recent California Master Plan for Aging (2021) and the California State Plan for Alzheimer’s Disease (2019): Individuals are living longer lives and California’s over-60 population is projected to grow faster than other age group. By 2030, 25% of California’s population is projected to be comprised of older adults.With the rise in older adults, California expects a doubling of the number of people with Alzheimer’s disease, the most common form of dementia and is a progressive, fatal brain disease for which there is no cure.Californians over age 50 are the fastest growing age group experiencing homelessness, and the median age of the homeless population is expected to continue to rise. Older adults without homes experience premature cognitive decline and mobility. In 2017, approximately 1,400 severely mentally ill offenders needed intensive psychiatric care in a community acute care setting; the provision of such care in the community is facilitated through a county PAPGPC program. Elder abuse is growing, which is estimated to impact 1 in 10 older adults living at home. A number of legislative initiatives have increased demand for PA|PG|PC services and escalated the complexity of our cases. Examples include: Incompetent to Stand Trial (IST) Felony Defendants: Legislative changes have shortened the period during which individuals deemed “Incompetent to Stand Trial” must become competent by the California Department of State Hospitals (DSH). Individuals who are unable to be restored to competency within specified timeframes are returned to the county and referred by the Superior Court to the county Public Guardian to initiate conservatorship proceedings for the defendant. As you may know, California and other states are seeing an unprecedented rise in individuals deemed to be IST, and Public Guardians are seeing a corresponding increase in conservatorship referrals. Given their criminal histories and significant mental health difficulties, individuals unable to be restored to competency present a substantially complex – and growing – number of cases county Public Guardians must manage. Parole and Community Supervision Violations: Following 2011 Public Safety Realignment, state law currently allows for a determination of competency for individuals that have violated the terms of their parole or community supervision. If found mentally incompetent, the court can refer such cases to the Public Guardian to initiate conservatorship proceedings as a means to meet the individual’s mental health needs.Elder and Dependent Abuse Reforms: California’s Omnibus Conservatorship Act of 2006 made sweeping reforms to California’s probate system and expanded the population for which a Public Guardian can be appointed, including when there is an imminent threat to a person’s health, safety, or estate. Given the Legislature’s and Governor’s interest in recent years to tackle California’s major challenges with homelessness, untreated serious mental illness, and its growing aging population, we anticipate additional policy proposals that could increase our responsibilities are likely forthcoming. In his 2020 State of the State Address, Governor Newsom expressed interest in revisiting the criteria for individuals with serious mental illness to qualify for court-appointed conservatorship; recent state legislation sought to do the same. Operating since the 1960s without any state or federal funding – but heavily impacted by legislative initiatives and court decisions – California’s dedicated PA|PG|PC public servants are now stretched to the limit. While a majority of health and social services programs were realigned from the state to counties in either 1991 or 2011 (with dedicated statewide tax revenues and mandate protections), PA|PG|PC services are supported entirely by county revenues. We respectfully request you consider providing $120 million ongoing in state resources to assist counties in caring for individuals who cannot care for themselves and are at-risk of victimization and personal harm. Thank you for considering this request, which I look forward to discussing with you. Please contact Scarlet Hughes, Executive Director of California State Association of PA|PG|PC at (916) 382-4757 or shughes@ with any questions you may have. Cc: Honorable Members, Senate Budget Subcommittee No. 3 Honorable Members, Assembly Budget Subcommittee No. 1 Scott Ogus, Senate Budget and Fiscal Review Subcommittee No. 3 Andrea Margolis, Assembly Committee on Budget Subcommittee No. 1 Keely Martin Bosler, Finance Director, California Department of Finance (DoF) Ana J. Matosantos, Cabinet Secretary, Office of Governor Gavin Newsom Dr. Mark Ghaly, Secretary, California Health and Human Services Agency (CHHS) Stephanie Welch, Deputy Secretary, CHHS William Lightbourne, Director, Department of Health Care Services (DHCS) Dr. Kelly Pfeifer, Deputy Director, Behavioral Health, DHCS Stephanie Clendenin, Director, Department of State Hospitals (DSH)Richard Figueroa, Office of the Governor Tam Ma, Office of the Governor Marjorie Swartz, Office of the Senate President Pro Tempore Chris Woods, Office of the Senate President Pro Tempore Agnes Lee, Office of the Speaker of the Assembly Jason Sisney, Office of the Speaker of the AssemblyJoe Parra, Senate Republican Fiscal Office Joe Shinstock, Assembly Republican Fiscal Office Corey Hashida, Legislative Analyst’s Office (LAO)Ben Johnson, LAO ................
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