Adults in DSS care could double

Published 12:00 am Wednesday, May 25, 2011

By Karissa Minn
SALISBURY ó The county social services departmentís adult guardianship caseload is set to double now that a local agency canít share it.
This means Rowan County will need to hire at least one more employee, officials said, in a tight budget year when the county is cutting other positions, department budgets and school funding.
A judge ruled in December that Piedmont Behavioral Healthcare cannot continue to provide adult guardianship services, and the agency has said it will end its guardianships this coming Wednesday to comply with the ruling.
Of the five counties served by the state-funded agency, Rowan will have the most legally incompetent adults now in need of guardians.
These 30 to 50 people will not necessarily all become wards of the social services department, but most donít have anyone else to represent them as guardians, said Rowan County Clerk of Court Jeff Barger.
PBH manages mental health, developmental disability and substance abuse services given by a network of providers in Rowan, Cabarrus, Davidson, Stanly and Union counties.
North Carolina Special Superior Court Judge Calvin Murphy ruled that Piedmont Behavioral has a conflict of interest because it decides which services Medicaid recipients can get, while also representing those recipients when they challenge its decisions.
Nancy Brandt, program administrator for the Rowan County Social Services Department, said it would be impossible for the department to handle a flood of new cases with its current budget and staff.
ěIt is something that we do, and weíre quite capable of doing it ó itís just that 30 at one time is a lot,î Brandt said. ěItís going to be a very challenging time to be able to take care of the state requirements for this situation while, of course, keeping the best interests of the client paramount.î
Social Services Director Sandra Wilkes said the department will have to hire one or two additional employees to take on the extra work and provide mental health expertise. This depends on the number of wards that are added to the current 30.
ěThirty cases would be a very large caseload for one person to handle, but I think itís doable,î Wilkes said. ěI understand there could be as many as 50 cases that we will be assigned.î
That includes about 20 wards currently represented by The Arc of Rowan, which supports people with mental retardation and other developmental disabilities. Piedmont Behavioral contracts some of its guardianships out to the nonprofit organization, but this also was ruled to be a conflict of interest.
After funding from Piedmont Behavioral runs out at the end of June, The Arc of Rowan may no longer be able represent its adult wards.
Itís not clear yet what will happen to Piedmont Behavioralís wards when June begins. The agency and clerk of court each say the other must take the next step.
Barger said the December court order only applies to the reassignment of one case. State law requires Piedmont Behavioral to file a motion in court for each of its wards to be reassigned, he said, but the agency has not done so.
ěPBH sent a letter saying that as of May 31 they will no longer be in the guardianship business,î Barger said. ěThey failed to realize they canít just quit. … They are still liable until the court changes that.î
But Richard Topping, general counsel for the agency, said that law only governs voluntary reassignment. The court order requires Barger to take action and find new guardians for all of its wards, he said.
ěAs of Dec. 28, 2010, PBH as a matter of law cannot be a guardian,î Topping said. ěWeíve continued services through the end of May, but as of June 1, the clerks need to find legal guardians for these folks.î
The two do agree that local social services departments will be burdened as a result. Barger said he hopes to find other agencies that could lessen that burden.
When an adult is found to be legally incompetent, or incapable of making informed decisions, the court appoints a legal guardian to make decisions on the adultís behalf. This is usually a family member or someone else interested in the personís welfare, Barger said.
In cases where no one is willing or qualified, Barger appoints wards either to the social services department or Piedmont Behavioral.
ěFor mental health issues I notice PBH, and for dementia and things like that I notice DSS,î he said. ěMy responsibility as clerk is to do whatís in the best interest of the ward.î
Contact reporter Karissa Minn at 704-797-4222.