Independent
work group will be led and convened by AARP Minnesota, in conjunction
with other senior organizations, to provide guidance on how the state
can better serve Minnesota seniors
Recommendations of the work group will inform legislative proposals ahead of 2018 Legislative Session
Among
requested recommendations are strategies to protect the rights of
residents and families, connect them to resources, and improve
communication about allegations of abuse
ST. PAUL, MN – Governor Mark
Dayton and AARP Minnesota Director Will Philips today announced a new
work group to provide guidance on steps the state should take to improve
the health and safety of Minnesota seniors who are cared for in nursing
homes and assisted living facilities. The new, independent work group
will be led and convened by the AARP, in conjunction with other
organizations serving Minnesota seniors, and will provide its
recommendations to state leaders ahead of the 2018 Legislative Session.
“I am deeply concerned
by recent reports of maltreatment, neglect, and abuse taking place in
those businesses, which families have entrusted for the care of their
loved ones,” said Governor Dayton. “I believe the
perspectives of seniors and their families should be at the center of
the discussions, as we work to ensure that Minnesota laws protect our
seniors. I thank AARP for agreeing to convene and lead this work group,
and I am committed to proposing legislation next year to improve
oversight of senior care and strengthen the rights of residents and
their families.”
In a letter to Director Philips,
Governor Dayton requests that the AARP-led work group also engage the
expertise of other consumer-focused senior organizations in the work
group process, including Mid-Minnesota Legal Aid, the Alzheimer’s
Association of Minnesota, the Elder Justice Center, and Elder Voice
Family Advocates.
“Caring for its most
vulnerable citizens is one of the greatest responsibilities of any
state. AARP is honored that Governor Dayton asked us to lead this
workgroup to better protect vulnerable adults and hold abusers
accountable,” said AARP Minnesota Director Will Phillips. “We
look forward to working with other consumer advocates and policy makers
to identify key policy changes to better protect Minnesota seniors.”
Among the recommendations the
work group may provide, Governor Dayton’s letter requests guidance for
state leaders focused on the needs of seniors who are cared for in
nursing home and assisted living settings, including:
· Protecting the rights of residents and families and connect them to resources.
o Review the current state
and federal regulatory, licensing, compliance, and enforcement
requirements, and recommend changes if these requirements are
insufficient to deter potential abuse and protect seniors and families
from retaliation from providers.
o Clarify and strengthen
the statutory definitions of memory care, assisted living, and housing
with services so consumers and families can make informed decisions on
proper placement for seniors.
o Recommend changes to
current law to ensure that family members are informed about how to
report suspected abuse and neglect, including the Minnesota Vulnerable
Adults Reporting Center and the Ombudsman for Long Term Care.
· Improving communication with family members and law enforcement about allegations of abuse.
o Recommend changes to
current law to remove barriers and improve communication with family
members when there is alleged abuse, including the complaints and
investigations processes within the Office of Health Facility Complaints
and self-reports from providers.
o Recommend changes to current law ensure proper reporting to law enforcement about potential abuse.
Efforts Already Underway to Protect Seniors and Improve Care
Last session, Governor Dayton
worked with the Legislature to secure new funding to increase staffing
and resources at Minnesota Department of Health (MDH) to more quickly
respond to and investigate alleged abuse of vulnerable adults. The
legislation also called for MDH to engage stakeholders in these
improvements. The new work group will build off of the feedback gathered
from MDH’s Request for Information from stakeholders, and the three
listening sessions the agency held this fall, which engaged hundreds of
seniors, families, and providers across Minnesota about senior care
issues.
The Administration is also
taking immediate action to shorten the timeframe to respond to
complaints and complete investigations into alleged abuse. MDH and the
Minnesota Department of Human Services (DHS) are collaborating to
implement a rigorous plan to improve processes and assessments of senior
care and safety, based on the successful changes that DHS has made to
their own licensing system.
North Carolina's program to provide guardianship for people with serious
mental health or intellectual issues is in need of updating. In a
multipart series, NC Health News will take a look at the issues around
guardianship and what might need to change.
By Taylor Knopf
A week before Shawn Stead’s 12th birthday, he was riding a scooter in his Garner neighborhood when a Ford F-150 truck hit him.
He suffered a traumatic brain injury (TBI), spending the first three
weeks at WakeMed hospital in Raleigh unconscious. Doctors said he would
likely die or be brain dead.
Shawn’s mother, Kristine Stead, said she needed hope of a better outcome.
“He said, ma’am, I don’t think you understand the severity of your son’s injuries,’” Kristine recalled the neurologist saying.
Kristine
Stead looks through the photo album she made of her son Shawn’s time in
recovery from a traumatic brain injury when he was 12 years old. Photo
credit: Taylor Knopf
“I don’t think you understand I’m his mother and I need a third
option, please. We need something else to hold on to,” she told the
doctor.
Shawn defied everyone’s expectations. After 78 days at the hospital, Shawn was discharged.
He relearned to walk and talk. He’s participated in Special Olympics. And he graduated from Garner High School.
“I was like a Pokemon, leveling up higher and higher,” said Shawn, now 22.
Though Shawn made a full-recovery physically, his brain was altered
in the accident. Daily life tasks are more difficult for him. He can’t
drive. And as Shawn approached 18, it was clear he wouldn’t join the
workforce and live independently right away.
Shawn’s mother Kristine is one of many parents in North Carolina who
have sought and secured a type of guardianship over her child.
Now, there’s a growing movement challenging parents to move away from
guardianship and think about other ways to support their children with
disabilities.
Some experts say it’s unnecessary to obtain guardianships in many
cases because young adults needs to make their own decisions in order to
mature into adulthood properly. NC Health News will examine that more
fully in Part 2 of this series.
But Kristine says the process has worked for her family and Shawn.
How it works
In North Carolina, there are a few types of guardianship.
A “guardian of the estate” is an adult appointed only to manage a ward’s property, estate and business affairs, according to N.C. general statute 35A.
A “guardian of the person” is an adult appointed only to manage the
care, custody and control of a someone the court deems “incompetent.”
And a “general guardian” is someone who controls a ward’s person and
estate.
A parent seeking guardianship must file a petition with the Clerk of
Superior Court and for parents seeking guardianship of their children
aging into adulthood, the court must find the teenager to be an
“incompetent child.”
The term is legally defined in the general statute
as “a minor who is at least 17 1/2 years of age and who, other than by
reason of minority, lacks sufficient capacity to make or communicate
important decisions concerning the child’s person, family, or property,
whether the lack of capacity is due to mental illness, mental
retardation, epilepsy, cerebral palsy, autism, inebriety, disease,
injury, or similar cause or condition.”
A guardian ad litem is appointed to represent the ward and make sure
he or she understands what is happening. The guardian ad litem also
talks to the ward about rights they may wish to keep, such as the
ability to vote, choose their own religion or pick friends.
This can be helpful for some families, like the Rainears of Raleigh.
Their 18-year-old son Gaven has autism and Asperger’s syndrome. While
Gaven has a pretty large vocabulary, he’s soft spoken and doesn’t always
tell people what he wants.
“We didn’t have any idea he would like to have the ability to pick
his own religion,” his father Russell Rainear said. “I’m fine with it.
You pick your religion, friends and who you vote for, absolutely. But I
wouldn’t have thought of any of those things had [the guardian ad litem]
not talked to him about it.”
Obtaining guardianship of an adult means taking individual rights
from them. It requires the person seeking guardianship to file a lawsuit
against the person they are seeking guardianship of.
Parents must inform family members via mail and give them an
opportunity to object. Law enforcement officers serve papers on the
wards to inform them a parent is seeking guardianship.
Kristine Stead found the process mostly pain free. After all the
paperwork was filed and the guardian ad litem met with Shawn, they
headed to the Wake County courthouse.
“The judge was sitting up at the bench when we walked in. He came
down from the bench, grabbed a chair and sat at the table with us,” she
said. “It was very informal — I think because we weren’t fighting
against someone [.…] Neither parent was fighting for custody.”
Kristine didn’t hire a lawyer because no one was contesting the guardianship.
Russell Rainear hired a lawyer. He and Gaven worried some relatives
might interfere. A couple clerks of court interviewed have said it is
not necessary to obtain a lawyer, but sometimes people do.
“A year before we filed the paperwork, we had conversations once a
month, reminding him that this was coming. This is how this will go.
It’s not a bad thing,” Russell said. “The officer is going to the house
in uniform and serve you papers. He’s going to tell you we are suing you
for guardianship of you… It’s a very intimidating process.”
Angela-Christine, Gaven and Russell Rainear at their home in Raleigh.
Angela-Christine Rainear, Gaven’s step-mother, said she thinks there
should be a different process for uncontested guardianships of people
with established disabilities.
“There should be a gentler, softer version,” she said. “Gaven didn’t contest to guardianship, but we still had to sue.”
The Rainears said they are dreading going through the guardianship
process again with their youngest son, who is 17 and also has autism.
Unlike Gaven, the younger boy is mostly non-verbal.
Peace of mind
Many parents of children with developmental disabilities see
guardianship as a way to protect their loved one. It gives them peace of
mind.
Kristine Stead said she sought guardianship of Shawn mainly for any medical need that might arise.
“If he needs to go to the doctor or has a procedure, I can go in.
There is no signing anything,” she said. “I go right in. They have to
answer my questions, they have to talk to me. It makes it easier.”
She added that if Shawn gets into a difficult situation, or makes a poor decision, she can override it as his legal guardian.
“Or if he makes a decision and it’s someone taking advantage of him, I
can come back and say, ‘you didn’t get my permission.'” Kristine said.
Russell Rainear feels similarly about Gaven.
“The world is going to expect him to walk out of high school, across that stage and be somebody he’s not ready to be,” he said.
“Gaven is a gem. You can take him anywhere. He’s super polite and
proper. He can carry himself well in general,” Russell added. “He just
can’t by himself. He won’t speak up for himself. He won’t take care of
himself. If left alone, he won’t make the right decisions.”
Both Kristine and Russell plan to restore their sons’ rights someday when the young men are ready.
Shawn has become more independent over time. He takes a cab when he
needs to go somewhere. He likes to run errands and go to the gym with
his grandfather.
He’s made small steps towards self-sufficiency, such as clipping his
own nails, doing laundry, emptying the dishwasher, and taking the trash
and recycling out on the right days.
When he got a job at Target recently, his mother was thrilled.
And Shawn’s fine with his mom being his guardian. It helps him out, he said.
Gaven said sees guardianship as a necessity.
“I’m incredibly less stressed now,” he said.
Gaven is excited to graduate from high school and building skills for
independent living. He’s starting to figure out the bus system.
He can prepare simple meals such as rice, mac ‘n’ cheese and frozen
pizza. And he does some chores, like folding clothes and emptying the
cat’s litter box.
He enjoys writing science fiction short stories and looks out for his
little brother. Gaven holds his brother’s hand and walks him to his
special education classroom every morning.
Is guardianship always necessary?
There is a growing movement challenging parents to move away from
guardianship and think about other ways to support their children with
disabilities.
“In North Carolina, we overuse guardianship,” said Corye Dunn, a lawyer with Disability Rights NC.
She said there are small number of cases where guardianship is
necessary. But Dunn and organizations such as Rethinking Guardianship
and First in Families NC believe in helping a young adult with
disabilities through supportive decision making.
“I think people really need to examine their goals in seeking
guardianship,” Dunn said. “There are important developmental
opportunities in those years between 18 and 25. Most young adults make
mistakes and that’s developmentally appropriate. That’s how you learn to
be an adult.”
Just because someone turns 18 does not mean they have all the
knowledge and skills to be a successful adult. Most young people turn to
trusted elders for advice, Dunn explained.
“Maybe you go to dad for financial help,” she said. “Or maybe it’s an aunt who is a nurse who you talk to about healthcare.”
For someone with a disability, the goal would be to formalize this support network for them.
“You create an agreement with the focus person and all the people in
their life who they trust to be advisors,” Dunn said. “The advisors
agree to be the advisors in specific areas and only those.”
Someone with a disability can give their power of attorney over if
needed or ask that a parent come into a doctor’s appointment with them.
Parents often focus on good decision making and keeping their child safe, Dunn said.
“As people, we balance safety against freedom, what we enjoy, and
long and short-term benefits,” she said. “If everything is about safety,
we deny them the human experience.”
