Private guardian surrenders license, sending vulnerable Alaskans back to public agency near collapse

An Anchorage Superior Court judge has reassigned dozens of cases from a private guardian facing allegations of neglect, sending them to the state agency that had previously sought to offload some of its cases to the private guardian.

But that public agency will not be able to accept all cases, its director said Monday.

The Office of Public Advocacy requested in 2022 for courts to approve the transfer of more than 60 of its cases to Tom McDuffie, who had launched a nonprofit private guardianship company but had not previously served as guardian. McDuffie was later accused of misconduct that left some of the state’s most vulnerable residents without the public benefits on which they relied.

McDuffie surrendered his guardianship license on Wednesday, rendering him unable to serve as guardian or conservator in the more than 100 cases that had been assigned to him and his nonprofit, Cache Integrity Services. He cited “concerning physical and mental health issues” in his decision to surrender the license, according to a court filing.

The decision came less than a month after the Daily News reported on mounting allegations of misconduct by McDuffie, and an Anchorage Superior Court judge was appointed to hold hearings on McDuffie’s fitness to serve as guardian.

Those court hearings were underway when McDuffie surrendered his license, compelling Anchorage Superior Court Judge Eric Aarseth to issue an order Monday assigning all but seven of McDuffie’s clients to the public guardians in the Office of Public Advocacy, or OPA.

OPA has since April declined to take on new guardianship cases, pointing to the same staff shortage that led them in 2022 to request dozens of cases be reassigned to McDuffie. OPA Director James Stinson said Monday that the public agency could take on only some of McDuffie’s former clients, not the entire 95-client list included in the court order.

[Earlier coverage: Alaska turned to a private guardianship agency to care for some of its most vulnerable residents. The result: dysfunction and debt.]

“OPA will take as many cases as it can and litigate as needed due to not having the capacity to accept this volume of cases,” Stinson said in an email.

In at least 20 cases previously under McDuffie’s care “the ward’s physical health or safety is in imminent danger without the assistance of a guardian,” according to Monday’s court order. In those cases, there is an “immediate potential for loss of housing and no viable emergency housing other than shelters, unattended health needs, and the distress of the ward having no contact with their guardian.”

In at least 20 other cases, “the status of benefits, timely payment of expenses such as housing, and timely medical care was in question.”

Before McDuffie surrendered his license, Aarseth had reviewed 67 of his cases, leaving 40 that had not been reviewed. Some are “likely in crisis,” Aarseth wrote.

‘Critical’ cases

Aarseth found that some of McDuffie’s cases “were in very poor order or critical” condition due to a lapse in Medicaid, neglect of medical needs, unstable housing, homelessness, not knowing the location of the client, or McDuffie never having met the client, even months after being appointed to a case. In all but one of those cases, OPA “had been previously appointed as guardian/conservator.”

OPA, which according to state law serves as guardian for individuals who cannot find or afford a private guardian, has been short-staffed — with caseloads far exceeding national recommendations — for years, according to public documents.

After OPA requested in 2022 that dozens of its cases to be transferred to McDuffie, OPA Deputy Director Beth Goldstein promised that the agency could reassume responsibility for the cases transferred to McDuffie “if there are issues.” But less than a year later, OPA told the courts it would no longer agree to take on new cases until the number of cases per guardian went down substantially. Still, the agency has failed to hire and retain enough guardians to significantly reduce its load.

Stinson said that a public guardian carrying 104 cases gave notice on Monday of their intent to resign. Another guardian with 101 cases is “unexpectedly hospitalized.”

The agency’s total caseload stands at 1,586 and many public guardians handle between 80 and 104 cases at a time, according to a November letter signed by Goldstein and Stinson.

In an interview last month, McDuffie acknowledged that after taking on dozens of cases in just a year, he had not fulfilled the basic requirements of a guardian in at least some of the cases, including by letting months go by without seeing some of his clients — who depended on him for their most basic needs.

Reached by phone last week, McDuffie declined to answer questions about his decision to surrender his license. McDuffie said he is “not giving out any information at this time” and hung up.

The court order issued Monday states that a court visitor submitted requests for review in 53 of McDuffie’s cases on Nov. 20, describing that “McDuffie was experiencing a medical emergency, that he felt unfit to continue his guardianship duties.” The court filings cited an email from McDuffie dated Nov. 19 “explaining his hospitalization and intent to surrender his professional license,” according to the court order.

‘Just a mess’

To explain his inability to meet the needs of some of his clients, McDuffie has pointed to decisions by some of his former staff members to leave Cache Integrity Services. In interviews, several of the former staff members said they left the agency because McDuffie expected them to take on more cases than they could handle.

One of those former staff members was Trudy Storch, who worked for McDuffie for several months before resigning in January. Storch, who continued to practice as a guardian after leaving Cache Integrity Services, had more than 20 guardianship and conservatorship clients as of last week. But her guardianship license expired on Wednesday, and she did not renew it, leaving an additional caseload of over 20 individuals without a guardian.

Storch said she decided to let her license expire because she had recently become the full time caretaker for her father, but also because of McDuffie, who she said was “constantly wanting to pull us into his drama and blame us for why his business failed.”

“It’s just a mess right now — the guardian world — and I just think it’s time to step away,” said Storch.

Storch said she had for weeks appealed to the courts to lighten her caseload, but the courts did not remove her as guardian, saying “‘we literally don’t have anyone else right now,’” by Storch’s telling.

“I felt like my only way out was just letting my license expire,” said Storch. “I was legally responsible and I wasn’t doing everything for every client.”

Storch said she is willing to continue helping her former clients when she can, but without active licenses, she and McDuffie are not allowed to sign any new documents or orders for their clients. Rebecca Koford, a spokesperson for the court system, said McDuffie’s and Storch’s clients can turn to court visitors if they have an immediate need — but the court visitors don’t have the authority to make decisions and sign paperwork.

That had already become a problem, according to Storch. On Monday, a home health provider called her and said they needed new documents signed to continue caring for one of Storch’s clients. Storch couldn’t sign the documents, but she didn’t know who else could, because the courts had yet to appoint a new guardian.

“They’re saying she doesn’t get home care anymore until the documents are signed. So who signs it? I don’t know,” said Storch.

‘The option of last resort’

Though the public guardian “is the option of last resort,” Aarseth wrote that “if a person is incapacitated and is in need of protection, the public guardian must fill that role of guardian/conservator if no other person is available.”

Whether or not OPA can decline guardianship cases is a question currently under consideration by the Alaska Supreme Court. If the court can order OPA to take on cases even when OPA objects, the public agency contends that would force it to accept new clients even if its staff does not have the ability to care for them. If the court cannot compel OPA to take on new clients, that could leave people in need of a public guardian — who are often handicapped or ill, are dependent on public benefits, and sometimes struggle with homelessness — with no one to submit benefits requests and make decisions on their behalf.

OPA was appointed to serve as guardian in all but seven of McDuffie’s cases — where a family member or other individual had been appointed. The new appointment was made without a hearing, but both the clients and OPA can object.

“The public guardian is in a very fragile situation,” Stinson said on Monday. “Accepting every case would be dishonest — there is no way the Public Guardian can provide the services these individuals deserve given the current lack of capacity.”

As the courts grapple with how to address the more than 120 cases previously handled by McDuffie and Storch, earlier this month, Goldstein and Stinson sent a letter telling the courts that OPA had the ability to take on only two new cases in Anchorage and two new cases in Palmer.

“Through the efforts of the current moratorium on accepting new guardianship and conservatorship appointments and internal caseload structuring, hiring and promotion, the Public Guardian currently has the immediate ability to accept a total of two new appointments from Anchorage two new appointments from Palmer,” Goldstein and Stinson wrote in their Nov. 20 letter, before McDuffie and Storch had surrendered or expired licenses.

Since announcing their moratorium on new cases in April, OPA has maintained a waitlist for guardianship clients. As of earlier this month, that list had eight would-be clients in Anchorage and four in Palmer.

“OPA wants to accept all of these cases, but it can only do so if it actually has the ability to help these people. We are looking at every option at our disposal,” Stinson wrote.

Stinson said in an email last week that the agency has “provided the court system with our waitlist and current wards per public guardian so the court visitors can prioritize appointments based on need.”

“It does no good to pretend that OPA accepting these cases solves the problem. It doesn’t. It will simply implode the last remaining leg of the guardianship system in the State of Alaska,” Stinson said Monday. “What happened to Cache Integrity can happen to OPA.”