John Fillbrandt Minnesota Department of Human Services June 21, 20110 Public Guardianship John Fillbrandt Minnesota Department of Human Services June 21, 20110

History and Background 1917 – Mental Retardation Guardianship Act State Schools - Hospitals

History and Background Current Demographics: Approximately 2300 Wards in Minnesota, Some dating back to 1920’s Public vs Private Guardianship

Authorities General Law by Reference: Minnesota Statutes 524.5 Minnesota Statutes 252A.01 to 252A.21 Minnesota Rules 9525.3010 to 9525.3100 General Law by Reference: Minnesota Statutes 524.5

Political Correctness Persons are Developmentally Disabled

Legal Terms Guardian Guardian ad litem Conservator Power of Attorney

Who is a Guardianship Candidate? “The person is an adult with mental retardation and impaired to the extent of lacking sufficient understanding or capacity to make or communicate responsible personal decisions, and who has demonstrated deficits in behavior which evidence an inability to meet personal needs for health and safety.”

CANDIDATES The person is in need of the supervision and protection of a guardian. That no appropriate alternatives to public guardianship exists that would be less restrictive of the person’s civil rights and liberties.

POWERS “The duty and power to exercise supervisory authority over the ward in a manner that limits civil rights and restricts personal freedom only to the extent necessary to provide needed care and services.”

POWERS Delegated vs Non-Delegated

Non-Delegated Powers Consent for DNR-DNI Consent to Limit Medical Treatment (LMT) Participation in Research

Non-Delegated Powers Consent for Electro-convulsive Therapy Sterilization Psychosurgery

Delegated POWERS General. Except as otherwise provided in this section, sections 524.5-207 and 524.5-313, apply to the powers and duties of a public guardian.

Delegated POWERS Determine Place of Residence Give necessary consent for medical or other care* (see non-delegated powers) Approve or withhold approval of contracts (marriage)

Delegated POWERS Consent to use Aversive or Deprivation Procedures Consent to use Psychotropic Medications Consent to be Photographed or Filmed Consent to Release Information

Delegated Powers Additional powers. In addition to the powers contained in sections 524.5-207 and 524.5-313, the powers of a public guardian that the court may grant include:

Delegated Powers the power to permit or withhold permission for the ward to marry; the power to begin legal action or defend against legal action in the name of the ward; and the power to consent to the adoption of the ward (MS 259.24, subd 3)

DUTIES Visit ward at least twice a year Take actions to maximize independent functioning and personal freedom Consult with family Submit Annual Review

Around ward’s birthday Annual Review Around ward’s birthday A. physical adjustment and progress; B. mental adjustment and progress; C. social adjustment and progress; and D. legal status based on A to C.

Duties Separation of Roles of Case Manager – Guardian Best-Interest Decisions for Ward

What does it mean to make Best-Interest Decisions for someone? ETHICS What does it mean to make Best-Interest Decisions for someone?

Special Problems Associations: Independence vs Risk Family Involvement Conservatorship Assets, Estates,

Darlene Luther Anatomical Gifts Act End-of-Life Do Not Resuscitate-Do Not Intubate Limited Medical Treatment – advance directives, hospice Organ Donation – Minnesota Statutes 525A.01 Darlene Luther Anatomical Gifts Act

End-of-Life Care of Remains Cremation Burial Customs

Contact John Fillbrandt 651-431-2441 John.Fillbrandt@state.mn.us Fax 651-431-7411 Department of Human Services PO Box 64967 St. Paul Minnesota 55164-0967