Geneva County AL December 18 2021 Geneva County Sheriff Tony Helms has a lot on his plate this December, including an unsolved homicide and a seasonal uptick in property crimes.

“The closer you get to Christmas, thefts increase, burglaries increase, scams have increased,” Helms said. “So, we’re working a lot of property crimes.”

On top of all of that, Helms agreed to buy and deliver holiday gifts to about a dozen people under his care as county guardian – a role assigned to sheriffs by state law. Only two states, Alabama and West Virginia, designate sheriffs as guardians of last resort, according to a 2005 review of state laws by the American Bar Association. It’s a duty that many say they’re not very equipped for.

Helms has about 25 wards, mostly older people unable to care for themselves who don’t have family members to step into that role. They are some of the most vulnerable citizens in the county. In addition to people with dementia, Helms acts as the guardian for some younger people with mental illnesses or disabilities.

Giving gifts and bringing cheer is one of the nicer parts of the job. The role of guardian is often much harder. Helms must make medical decisions and decide where a person will live. Between law enforcement calls, he waits for nursing homes to get back to him about available beds.

“It should be a family member doing this,” Helms said. “But sometimes the family can’t for one reason or another.”

Alabama law says the sheriff will serve as the guardian of last resort for people without family or friends able to step into that role. Helms estimated that about two-thirds of the sheriffs in Alabama serve as guardians.

Many of the state’s larger counties have shifted the job to professional guardians. But rural counties still rely on top law enforcement officers to provide care to some of their most vulnerable citizens. An informal poll by the Alabama Sheriff’s Association found more than 40 departments where sheriffs also serve as public guardians.

Helms says the job of public guardian is one of many non-law enforcement duties his office handles. Geneva is a poor county with a dwindling tax base and few safety-net services. He and his deputies often respond to mental health calls and family disputes.

“The old joke is, when all else fails, call the sheriff,” Helms said.

Helms, who grew up in Geneva County, tries to be a responsible steward of public money. His office sits in a small wing of the county courthouse that he never expanded, citing cost.

His 10 full- and part-time patrol officers police almost all of the county’s 585 square miles, which are dotted with peanut and cotton farms. Technological changes and free trade agreements decimated the local textile industry, Helms said.

The county’s population has held steady at about 26,000, but many of its residents are getting older. Guardianships happen when someone – usually a doctor – determines that a person can no longer care for themselves, Helms said.

One of the most famous examples of this kind of legal arrangement involved Britney Spears, who recently had her conservatorship dissolved.

In Alabama, a conservatorship is granted for financial decisions. In Spears’ case, her conservatorship also covered personal decisions, which are handled by guardians in Alabama. Probate courts can appoint family members as guardians and conservators or professionals, who often step in if family members aren’t available or can’t agree about a relative’s needs.

Helms has no control over his wards’ finances. Those are handled by a separate county conservator. He makes decisions about where they live, what kind of medical care they will receive and how they will be buried.

Alabama sheriffs are trying to get out of the guardianship business. In 2021, the Alabama Sheriffs Association proposed a bill that would change the Alabama guardianship law and remove sheriffs from the role. It died in committee.

Montgomery County Sheriff Derrick Cunningham, former president of the Alabama Sheriff’s Association, said law enforcement officers aren’t equipped to serve as guardians. He said it would be better to put people with backgrounds in social work or health care in charge of vulnerable citizens.

“We’re not qualified to do it,” Cunningham said. “I’ll just come out and say it.”

Helms worked in the Geneva County Sheriff’s Department before taking over, and he knew he would serve as public guardian. But his caseload has ballooned in recent years, up to a pre-COVID high of about three dozen people.

People are growing older, and cases of dementia have increased. The Urban Institute estimates the number of people ages 85 and older will more than double between 2020 and 2040. Researchers at the Institute for Health Metrics and Evaluation at the University of Washington have estimated the worldwide prevalence of dementia could triple by 2050.

Some people lack family or community support as they age. Naomi Karp, an expert on aging and the law, said states have created a patchwork of different systems to meet the demand for public guardians.

“It’s quite variable around the country in terms of whether there are public guardians programs, how well-resourced they are, how well qualified and trained they are, whether they have very large caseloads and that makes it really hard to give good service to an individual who’s in that caseload,” Karp said.

Providing well-qualified guardians for people with few resources has been a problem for several decades, Karp said.

“We have a set of people who are not able to make their own decisions, either in the financial realm or the personal realm or both and just don’t have someone available to serve,” Karp said.

John Craft, an elder law expert at Faulkner University School of Law in Montgomery, said advocates in Alabama have increased efforts to train guardians in the state. He agreed that sheriffs may not have adequate training to serve as guardians.

“But if they don’t do it, who else is going to do it?” Craft asked.

Some states have created networks of professional guardians. In some Alabama counties, volunteers can step up to help. Although Alabama cities usually have professional guardians, the state does not have a system in place to provide them for smaller towns and rural areas, Craft said. Creating such a system would require funding, Craft said.

Craft serves on a committee created by the Alabama Supreme Court to improve guardianships and conservatorships in the state. It has focused on increasing training and education for those who serve in those roles. People placed under guardianships and conservatorships often face high risks of abuse and exploitation and need qualified help, he said.

Helms does not receive additional money to perform his guardianship duties. A social worker assists with many of the tasks required for the job, but much of the burden still falls to the sheriff.

Often an elderly person will wind up in the hospital where he or she is deemed incompetent. If hospital staff can’t find a family member, Helms and the social worker must determine whether that person can return home with assistance or move into a nursing home. His elderly and disabled charges usually qualify for Medicaid or Medicare, which will pay for those services.

Finding an open bed often poses a challenge. Geneva County, which sits near the borders of Georgia and Florida, has two nursing homes and an assisted living facility. If they are full, Helms must look elsewhere, even across state lines, for available beds – a task made more challenging during COVID, when hospitals needed beds and nursing homes required two weeks of quarantine to accept new residents.

He tries to keep in touch with the people under his care, but COVID has also made that more difficult. Still, he regularly talks on the phone to catch up with those who are still able to communicate.

In addition to the major decisions, Helms must often weigh in on issues well outside his training in law enforcement. At one point, he received a call from a nursing home in Florida where one of his most challenging cases lived.

“She’s always got to have a boyfriend,” Helms said. “I got a call. It turns out, they allow civil unions at this nursing home. A lot of nursing homes do now. And she’s got a boyfriend. And they will allow them to cohabitate in a room. His family was ok with it. They had signed off on it. Would I sign off on it?”

He did and the woman lived with her boyfriend until he died from COVID-19, Helms said. She survived, but the virus devastated the people in his care. The number of people under his guardianship dropped from 36 to about 25. It changes all the time, and in early December, he expected to get two more cases from the probate court.

In addition to holiday gifts, Helms will bring special food and treats to those in his care. One man craved chili dogs and friend chicken. Another loved his truck so much that Helms and the conservator agreed not to sell it and instead parked it in front of his room at the nursing home. He couldn’t drive but would go outside and admire it.

Helms also must make critical medical decisions – often about end-of-life care. Some of his charges can’t tell him what they want, but he tries to consider their wishes and dignity when determining care.

The same goes for funerals. Helms tries to prepay for funeral arrangements while his charges are still alive. If that doesn’t happen, he may wind up making burial arrangements.

Helms attends the funerals for all who pass away under his care. Some may have family who are either unwilling or unable to take care of a loved one. But others don’t have any known family members or friends when they die.

“I had one pass away and it was myself, the county conservator, the funeral home director and the vault company grave digger and we were the only ones there,” Helms said. “That really kind of brings it home to you.”
AL.com

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