Kurt Falke sat in his room in a residential hotel in Anchorage, reflecting on the second guardian the state assigned him. He said he appreciates the work his guardian did behind the scenes
“I was recovering from my brain damage and I was pretty much a kid,” Falke said. “He was working with other people without me being aware of it, my counselors and all this.”
Falke’s had guardians on and off since the mid 1990s. That’s because he was homeless and struggling with substance abuse and later suffered a serious head injury. He tears up when he talks about how one of his guardians, Ezra Stone, helped him change his life for the better.
“Ezra, Ezra stone- He became my friend and I started to learn how to trust somebody because I started trusting myself,” Falke said.
Guardians are assigned to people by the courts when they aren’t able to make important decisions for themselves. That may be because of an injury, a mental disability or illness, or because of dementia. Guardians can then help with or make decisions about medical care, housing, finances, or even real estate on behalf of their clients.
But patients throughout Alaska have been denied new guardians over the past seven months. Since April, OPA stopped taking all new assignments of guardians and conservators because of a severe staffing shortage. Guardians now have 80 to 100 cases on their plate instead of the recommended 20-40.
Falke said the guardian he works with now is great at his job and cares.
“David Harper- Now, he’s a good kid. He tries real hard,” Falke said.
But he said Harper has way too many cases on his plate to be able to help everyone.
“It was about 20 then it went up to 50 then 100 and now David’s like ‘oof.’ He’s swamped,” Falke said.
James Stinson, director at OPA, co-signed a letter to the courts in April saying OPA’s staffing crisis is partially because a number of public guardians retired or resigned. Stinson said this guardianship crisis is about more than just OPA.
“It’s not just that case loads are continuing to grow,” Stinson said. “It’s also that all of the things that a public guardian depends on to provide services for their wards are becoming more and more constrained and much more scarce. And the hiring pool has changed considerably.”
Stinson said they’ve done some hiring, but it typically takes two years for guardians to be fully trained on their job. That’s because they need a vast variety of expertise to be able to help people with decisions ranging from real estate to healthcare.
Right now, guardians at OPA have two to three times what Stinson said is a typical maximum caseload. And because of the state supreme court’s order, OPA has to continue putting more cases on Guardian’s plates no matter how many they have. Stinson said that means guardians won’t be able to do their jobs well.
“Public guardians are just people and they’re people that want to do a good job, and the staffing situation we’re in is a candle burning on both ends,” Stinson said. “You can’t afford to overload your most experienced guardians to the point that they just give up and quit because they just can’t do anything because that’s disastrous. And you can’t place a bunch of cases on somebody who’s new and inexperienced, who doesn’t know how to do it either.”
He said he’s worried Guardians will get burnt out and quit, which will make the problem worse.
Corinne O’Niell, senior director of care management for Providence Alaska Medical Center, said most people have friends or family that can make decisions for them. But not everyone has that and that’s when they need an appointed guardian.
“They’re some of the most vulnerable people in Alaska because they just don’t have anybody that can step in and fill that role of a guardian,” O’Niell said.
O’Niell said that if someone can’t get a guardian after medical care, they might have to stay in the hospital for longer than needed.
“We can’t safely discharge them to the community, because we have nobody to sign their paperwork to go into a long term care facility, or an assisted living facility, or sign for their durable medical equipment, because they can’t understand those decisions and we don’t have a guardian appointed,” O’Niell said.
And she said that impacts healthcare for all Alaskans.
“Even when we tie up one bed or two beds, or five beds for long periods of time, those are beds that are then not available right to the general public to get the right care that they need at the right time,” said O’Niell.
She also said Alaskans should consider creating an advanced care directive just in case of injury or illness. She said it can help prevent the need for a guardian to make decisions for you.
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Rachel Cassandra covers health and wellness for Alaska Public Media. Reach her atrcassandra@alaskapublic.org. Read more about Rachel here.
