DeSantis, Florida lawmakers consider changes in troubled guardianship program

Gov. Ron DeSantis administration officials on Monday plan to meet with guardianship associations, court officials and the Department of Elder Affairs to discuss a crisis facing Florida’s guardianship program. (Joe Cavaretta / South Florida Sun Sentinel) (Joe Cavaretta / South Florida Sun Sentinel)

By Gray Rohrer

TALLAHASSEE — Changes could be coming to Florida’s system for overseeing the guardians of elderly who are no longer able to care for themselves, including beefing up monitoring and increasing penalties for those with valid complaints against them.

Legislative leaders and officials of Gov. Ron DeSantis’ administration on Monday met with judges, guardianship trade groups, state attorneys and representatives of the Elderly Law section of the Florida Bar to discuss ways to protect seniors from exploitative or neglectful guardians.

“More must be done to enhance the structure of accountability for guardians to monitor compliance with established standards of practice and ensure that guardians are acting in the best interests of their wards," Department of Elder Affairs Secretary Richard Prudom said. "The matter is complex, and the solution extends beyond the Department of Elder Affairs; families, local communities, and public officials must also work together to prevent all forms of exploitation to provide safety and security for all.”

The revelations this summer about guardian Rebecca Fierle, who investigators say was responsible for more than 400 wards and regularly signed Do Not Resuscitate orders for clients against their wishes, have renewed interest among lawmakers of increasing oversight of the state’s 550 registered guardians.

Sen. Kathleen Passidomo, R-Naples, and Rep. Colleen Burton, R-Lakeland, took part in the meeting Monday and said some of the ideas being discussed include capping the number of cases each guardian can take on and requiring a judge to approve a DNR order. They also include increased standards for guardians and more thorough monitoring.

More stringent penalties for guardians who violate the law could be in the works as well, but judges would likely still have to approve the removal of any guardian from the state registry, which could be appealed.

The lawmakers suggested that more money for the courts to address the caseload isn’t necessary, nor is there a need to increase the requirements to become a guardian. All that is required currently is a 40-hour course and passing an exam.

Passidomo said the problem isn’t a lack of competence, but the risk for abuse, so standards and monitoring of guardians need to be increased.

But for the moment, those ideas are merely being discussed. Lawmakers have yet to come out with a concrete plan.

DeSantis’ administration will publish a budget request for the Department of Elder Affairs, which houses the Office of Public and Professional Guardians, on Tuesday which could include more funds for investigators to review complaints.

The OPPG has four employees, and Prudom has taken the reins of the department since July, when he asked Carol Berkowitz, the agency’s executive director, to resign as a result of the Fierle case.

Fierle was responsible for more than 400 wards, including some in other states, and a report from the Orange County Comptroller’s Office released last week claims she double-billed AdventHealth for nearly $4 million over a 10-year period.

Prudom said he’s looking to fill the OPPG director position soon, likely before the end of the year, and despite the small number of employees in the office, it will be able to investigate every complaint.

The issues with the guardianship system aren’t new and have plagued the office nearly since its inception.

Rep. James Grant recalled that his father, John, a former representative and senator, helped create the legacy agency known as the Statewide Public Guardianship Office. John Grant was appointed by then-Gov. Jeb Bush as its first director in the early 2000s when Grant was in high school.

“I had a little bit of a front-row seat to the office of the Statewide Public Guardianship,” said Grant, R-Tampa. “Quite frankly, the reason my dad left the office of the (office) and walked away from a pretty good gig ... is that there was no funding.”

Lawmakers increased the OPPG budget by $2.5 million this year, but much of it went to clear a waitlist of 453 wards and increasing the amount paid to guardians by $428.71 per ward.

Grant said more funding could be looked at but the state should also consider improving data collection on guardians to improve monitoring of cases.

“We should at a minimum be able to identify where a guardian is operating,” Grant said.

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DeSantis, Florida lawmakers consider changes in troubled guardianship program

DeSantis launches probe of office overseeing guardians after death, resignation; advocates want action

Carol Berkowitz

Gov. Ron DeSantis said Wednesday his administration is “vigorously” investigating the state office overseeing professional guardians in the wake of its director’s sudden resignation, adding he may ask for legislation to fix the beleaguered system.

The Orlando Sentinel reported this month that a man died after professional guardian Rebecca Fierle of Orlando issued a “do not resuscitate” order against his wishes. A judge found Fierle had “abused her powers” by filing such orders for numerous incapacitated clients without permission from their families or the court. Fierle resigned from 95 Orange County cases during a July 11 hearing.

The next week, she resigned from additional cases in Seminole County during an emergency court hearing, but it was not immediately clear how many cases were involved because the hearing was closed to the public.

Carol Berkowitz, executive director of the Florida Office of Public and Professional Guardians, which oversees investigations and discipline of the more than 550 professional guardians in the state, abruptly resigned July 12, three days after the Okaloosa County Clerk of Court and Comptroller produced an investigative report on Fierle. The state’s Department of Elder Affairs confirmed Berkowitz’s resignation Tuesday but has not said what led to her departure.

 “We were obviously concerned with some of the reports,” DeSantis said at an event at the Florida’s Turnpike headquarters in Ocoee. Richard Prudom, the secretary of Elder Affairs, “is pursuing it, and I told him to pursue it vigorously.”

He said he told all agencies to “take six months, you’ll figure out what’s going on, figure out what needs to be done,” adding the agency heads have been reporting back to him over the course of July.

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DeSantis launches probe of office overseeing guardians after death, resignation; advocates want action

Florida Elder Affairs chief details changes to troubled guardianship program, says he asked top official to resign

Carol Berkowitz resigned as executive director of the Florida Office of Public and Private Guardians on July 12, 2019. (Florida State Guardianship Assn.)

Florida Department of Elder Affairs Secretary Richard Prudom’s office revealed Wednesday that he asked the state’s top guardianship official to resign after learning of a “significant backlog” of cases and that he has since worked to close those cases and address the complaints.

“Secretary Prudom is leading the Office of Public and Professional Guardians and has made and will continue to make administrative changes moving forward,” the department’s spokeswoman, Ashley Chambers, said in an email to the Orlando Sentinel. “… He was made aware of the significant backlog of cases needing completion.”

Prudom, in an interview with Spectrum News, said that backlog had more than 80 complaints against guardians — all of them since closed.

"We have made mistakes in our office. We have not processed these complaints as efficiently and quickly as we need to," Prudom said in that interview. "We need to be more responsive to the complainants and their rights. I take personal responsibility for that. … I’m really sorry. It should have never come to this."

The Orlando Sentinel reported July 23 that Carol Berkowitz, the executive director of the Office of Public and Professional Guardians – the state agency that handles complaints and discipline of more than 550 professional guardians in Florida — had resigned abruptly after officials began investigating Orlando guardian Rebecca Fierle for placing do-not-resuscitate orders for people against their will and without court permission.

At the time, neither Prudom nor Berkowitz would comment on the reasons for her departure. Prudom’s office has not responded to requests from the Sentinel for an interview with the secretary.

The firestorm surrounding Fierle began after the death of Steven Stryker, a 75-year-old Cocoa man to whom Fierle had been appointed as a guardian. Investigators found that Stryker died at a Tampa hospital after staff could not perform life-saving procedures because of a DNR order Fierle filed against his wishes.

Chambers said Prudom has been working with the staff of OPPG to close backlogged cases and reply to the complainants with its findings. He also has changed how the investigations are handled, she said.

“Once an investigation has been completed, the report and its findings will be shared with the complainant and the guardian rather than waiting for the administrative [disciplinary] process to take place,” Chambers said.

Prudom is also streamlining the investigations to focus on complaints that indicate the guardian may have broken the law, and he will “continue to work on long term solutions, including legislative recommendations” for the next session of the Florida Legislature.

Late last week, Fierle resigned from all her cases statewide, writing that she would not seek to be reappointed to any cases already taken from her or seek to be appointed as a guardian again in the future.

She had once been a guardian in at least 13 Florida counties and handled 95 cases in Orange County alone. Guardians are appointed by judges when someone is deemed to be incapable of making decisions on their health, property or personal matters.

There is statewide guardianship complaint line, run by the Office of Public and Professional Guardians: 1-855-305-3030. Complaints can also be submitted on the guardianship webpage at elderaffairs.state.fl.us/doea/oppg_complaint.html.

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Florida Elder Affairs chief details changes to troubled guardianship program, says he asked top official to resign