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HEARING - Health and Human Services Agency (HHSA) recommending the Board adopt and authorize the Chair to sign Resolution 004-2026, implementing an updated Public Guardian Fee Schedule (Exhibit A) for fiduciary and case management services, effective on March 7, 2026, and authorizing the Public Guardian’s Office (Public Guardian) with approval by County Counsel, to reduce or waive Public Guardian fees, either as negotiated with the Public Defender or as ordered by the court, thereby replacing Board adopted Resolution 142-2017.
FUNDING: 2% Medi-Cal Administrative Activities, 3% Fee for Service and 95% County General Fund.
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DISCUSSION / BACKGROUND:
Public Guardian provides fiduciary and case management services for individuals who are under conservatorship or guardianship who are gravely disabled, cognitively impaired, or otherwise unable to manage their personal or financial affairs. Public Guardian provides these services when there is no one else legally qualified or willing to act on their behalf. Services include managing estates, coordinating medical and social services, and ensuring the safety and well-being of vulnerable residents.
The Public Guardian Program is a mandated County service, authorized under California Government Code Sections 27431 and 27431, California Probate Code Section 2920, and California Welfare and Institutions Code (WIC) Sections 5352 and 5354.5. Additionally, California Rules of Court, Rule 7.756, establishes standards for determining just and reasonable compensation for conservators and guardians, ensuring that fees are fair and reflect the scope of services provided.
On September 12, 2017, the Board approved the current Public Guardian Fee Schedule which implemented an hourly billing model through Resolution 142-2017, which has been in effect since November 11, 2017 (Legistar file 16-0805, V. 3). In 2024, HHSA Community Services commissioned MGT Consulting (MGT) to conduct a fee study for County Senior Day Care sites and Public Guardian services. The primary objectives of the study were to determine the full cost of providing fee-related services, assess whether fees should be introduced or adjusted, identify opportunities to align fees with the actual cost of services while considering economic and policy factors, and develop revenue projections based on potential fee increases or decreases.
On March 4, 2025, the Board received and filed the fee study report dated June 2024, conducted by MGT, and heard a presentation from HHSA staff outlining proposed fee increases with the study recommendation of transitioning from an hourly model to a flat fee model to improve cost transparency, streamline administrative processes, and better reflect the actual cost of services by reducing program expenses (Legistar file 25-0144). In this agenda item, the Board directed Public Guardian to consult with the California Superior Courts and the Public Defender to determine if there were any objections to the proposed flat fee model; explore if the services were required to be provided with state funding; and requested that Public Guardian explore incorporating an annual Consumer Price Index (CPI) adjustment. The Board also directed Public Guardian to explore asking for a full recovery of extraordinary compensation. Following this analysis, the Board requested Public Guardian return to Board with a resolution to increase Public Guardian Program fees.
Public Guardian has completed the analysis/actions requested by the Board with the conclusions as follows: The California Superior Courts and the Public Defender’s office have no objections to the proposed fee structure, agreed to use flat fees and to include the annual CPI adjustment in the proposed fee schedule. Pursuant to WIC 5352.5(d) Lanterman-Petris-Short (LPS) Act, conservator investigation services and case management services are reimbursed with mental health services state funding under the Short-Doyle Act. These services are required to be provided by the County even in the absence of dedicated state or federal funding, as the statutory mandate is not contingent upon external financial support.
As proposed, this new fee schedule includes increasing the extraordinary compensation rate from $149 per hour, which reflects a 95% cost recovery, to $156 per hour, which reflects a 100% cost recovery, and implements a flat fee structure for standard services. The proposed fee changes are projected to increase annual revenue by approximately $587,512 and result in an overall cost recovery of $672,906, equal to 37% of the County's total program costs. The proposed changes aim to support more efficient service delivery, improve the financial sustainability of the program, and provide greater clarity regarding service costs.
As required, a Notice of Public Hearing was published in both the Mountain Democrat and the Tahoe Tribune, announcing that the Board would conduct a public hearing on this agenda item.
HHSA is recommending the Board adopt and authorize the Chair to sign the attached Resolution, thereby adopting and approving Public Guardian Fees as outlined in Exhibit A, which effective March 7, 2026, will replace and supersede Resolution 142-2017.
ALTERNATIVES:
Should the Board decline to adopt the Resolution, the current fees would remain the same for HHSA Public Guardian program, resulting in continued increase in General Fund expenditures. The County may face significant challenges in maintaining the financial sustainability of its Public Guardian program without an updated fee structure that reflects the actual cost of services.
PRIOR BOARD ACTION:
1) 08/30/16, 16-0805 V.1, HHSA, Resolution Establishing Fees for Fiscal Year 2016-2017
2) 09/12/17, 16-0805 V. 3, HHSA, Resolution Revising Public Guardian Fees for Fiscal Year 2017-2018
3) 03/04/25, 25-0144, HHSA Senior Day and Public Guardian Fee Study
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
County Counsel
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
The Public Guardian program is funded primarily with General Fund dollars, offset by any fee revenue that is received. This new Public Guardian Fee Schedule includes increasing the compensation rate which will result in a 100% cost recovery and implements a flat fee structure for standard services. The proposed fee changes are projected to increase annual revenue by approximately $587,512 and result in an overall cost recovery of $672,906, which is projected to decrease the General Fund cost, equal to 37% of the County's total program costs.
CLERK OF THE BOARD FOLLOW UP ACTIONS:
Clerk of the Board to obtain signature of Chair on one original Resolution.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT:
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency