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Spring 2017 Newsletter

3rd Annual WINGS MN 
Guardianship Summit
Recap

WINGS Minnesota hosted its 3rd Annual Guardianship Summit* on 2/3/17.  More than 125 social workers, advocates, attorneys, case managers, professional guardians and human service and health care professionals participated.  The Summit was free, with meals and refreshments provided with donations from National Guardianship Association, MN’s CAAP program, and individual donors. The stage for the day's priorities was set by MN Supreme Court Chief Justice Lorie Skjerven Gildea and MN Department of Human Services Assistant Commissioner Claire Wilson, both of whom emphasized the importance of improving guardianship systems and their support of WINGS MN's goals to do so.
 
A robust agenda of speakers and topics continued the conversation begun in past WINGS MN events to address current guardianship practices: observation of what is working well and how the system could be improved with application of emerging national trends and activities.
 
Genevieve Gaboriault, of Mid-Minnesota Legal Aid, formally introduced the PRACTICAL Tool, developed by the American Bar Association with assistance from the National Resource Center for Supported Decision-Making, as a comprehensive assessment tool for attorneys, or anyone contemplating the need for guardianship, to identify and facilitate less restrictive approaches.
 
Doug Nguyen, Regional Communications Director (Chicago) for the Social Security Administration made a presentation on the use of SSA's Representative Payee Program as a tool to protect against financial exploitation outside of guardianship/conservatorship as well as SSA's available support and education, specifically the new interdisciplinary training series (see link following this article).
 
Professor Thaddeus Pope, Director of Mitchell Hamline School of Law's Health Law Institute in St. Paul engaged the audience with his Better Healthcare Decision Making for Incapacitated Persons without Surrogate Decision Makers presentation.  He described that many states address the problem with default surrogate consent legislation, wherein family members, listed by priority status, would be the legal decision maker in absence of other legally appointed decision maker.  MN does not have such legislation, for good or bad, and often health care systems' policies and procedures need to, and can, resolve the conflict in the hospital setting.
 
WINGS MN has been working hard to bring concepts of Supported Decision Making to Minnesota: introducing the philosophy, and a viable less restrictive alternative to guardianship.  Jonathan Martinis of The Burton Blatt Institute at Syracuse University, appeared via phone to provide the national perspective and successes for individuals, followed by presentations from Joanne Taylor, Nidus Personal Planning Resource Centre and Registry in Vancouver British Columbia and Helen Gaebler, William Wayne Justice Center for Public Interest Law, University of Texas-Austin about their state/province's experience with supported decision making legislation.
 
Finally, we wrapped up the day with a facilitated question and answer session with a panel of experts: Moderated by Ben Ashley-Wurtmann, Summit speakers were joined by Honoring Choices Minnesota’s Executive Director Karen Peterson, Jennifer Wright, St. Thomas School of Law, and Robert McLeod, Briggs and Morgan, and a call to action where attendees were asked to contemplate and share what they would take back to their practice settings as a result of the day's discussion.   99% of attendees who completed post-event surveys reported they had gained at least one actionable item to take back to their work setting.  Feedback was overwhelming positive, and Helen Gaebler summed it up perfectly:  The energy and engagement was terrific and it was great to ... have the opportunity to connect with so many of the folks working on these issues.  I hope that we can continue to keep each other informed of progress and to share the ideas that are bubbling up in our respective communities.  The more collaborators and pooled experience the better!  

(Link to Summit handouts available below photos)


WINGS MN will continue efforts to improve guardianship through: outreach and education to professional and community groups regarding alternatives to, and appropriate use of, guardianship; support and education of people serving as guardians or other surrogate decision-makers, especially family members who find fewer opportunities developed for them than for professionals in our current systems; and continued exploration of interest in legislative change in supported decision making and/or default surrogacy consent practices in Minnesota.  Contact us at CESDM@voamn.org with comments, questions, or to inquire about education/training in your region.

Actionable Ideas attendees stated they will take back to work settings:
Utilize PRACTICAL to determine appropriate representative agreements / guardianship   //   Talking about the principles of PRACTICAL to parents who come with questions on guardianship // Using WINGS, PRACTICAL and SDM in our new collaborative framework   //   Presume guardianship isn't needed (PRACTICAL tool) maximize opportunities   //   Talk to transition age students and their families about alternatives to guardianship   //    Be an advocate for trying something before guardianship is instated   //   The need to diligently search for a surrogate // Explore a variety of other options first   //   Keep pushing (uphill ) to utilize alternatives   //   Steps to help individuals have a voice with supported decision-making practices   //   Review current guardianships and determine if it is still needed/appropriate   //   Concept of lacking capacity in one area doesn’t mean a person lacks capacity in all areas   //   View of decision-making capacity as a continuum rather than all or nothing   //   To call someone “incapable” how arrogant (seems true).  “Laws don’t make people safe, people make people safe.”   //   Shifts to present when considering if someone has capacity – be more cautious when recommending guardianship   //   Provide more education on definition and purpose of decision-making tools to interdisciplinary team.  Invite speaker for dignity of risk vs. fear of liability
Concerns / obstacles expressed by attendees:
Trying to do this in a system that, as a whole, wasn't’t designed to go in this direction   //   Getting MDs to accept the idea of supported decision making   //   Lack of understanding/willingness to understand by other providers   //  Some families have a difficult time allowing dignity of risk   //   Push back from guardians   //   Finding audience that would like to hear this message.  All need it, but few will take the time to hear the message   //   Alternatives to guardianship. It is still so new to teachers, case managers, health care professionals   //   Social culture that resists challenges to plenary guardianship   //   I believe there are many guardians that will be offended by this   //  Differing perspectives on guardianship   //   We continue to struggle with decisions on how to proceed with individuals who decline any support in decision-making and/or with services.  Would like to hear opinion on when guardianship is appropriate   //   Cultural obstacles   //   Non-English speakers, faiths and beliefs   //   No state laws/mandates, liabilities of medical practitioners   //   Schools and medical providers are very concerned about liability; law changes are needed to legally sanction supported person centered decision making and to support surrogate decision making   //   Medical facilities and nursing home facilities—how to address their fears re: liability.  Would like to see MN adopt a default surrogate decision-maker list   //   Attorneys/Judges and parents / professionals who need to learn more about person-centered learning and risk taking for people with BD? And promote this philosophy   //   Petition paperwork (and Judges do all or nothing – Judges need education) limitations. Need to update to include limited guardianship/supportive decision-making   //   The current judicial/court system   //   Accountability without court oversight   //  POAs can often take advantage and steal from vulnerable adults – they aren't’t monitored and have little accountability. Stolen funds cannot be returned. Conservators are monitored through reporting requirements and are bonded to protect the vulnerable adult   //   Once put into practice with an actual case, is always more challenging than learning about it   //   MN needs to make this a priority 
* This summit was supported in part by a grant (No. 90EJIG0002-01-00) from the Administration for Community Living, U.S. Department of Health and Human Services (HHS). Grantees carrying out projects under government sponsorship are encouraged to express freely their findings and conclusions. Therefore, points of view or opinions do not necessarily represent official Administration for Community Living or DHHS policy.
 
Panel Q&A
Chief Justice Gildea
 
Marit Peterson, MEJC
Anita Raymond, CESDM / VOAMN
Patricia Siebert,
MN Disability Law Center
 
Summit Handouts Available Here (access via Google Chrome for best results)
Ben Ashley-Wurtmann &
DHS Assistant Commissioner
Claire Wilson
Doug Nguyen, SSA

 
NEW Resource from The Burton Blatt Institute (BBI) at Syracuse University:
  "Supported Decision Making Teams: Setting the Wheels in Motion."
This guide, by Suzanne M. Francisco, Special Education and Disability Rights Advocate & Jonathan G. Martinis, Esquire, provides information, strategies, and worksheets to help jump start the SDM process; while developed for families and persons with disabilities, it lays the groundwork for professionals working with families who are brand new to the idea of SDM as an alternative to guardianship.
Download at:http://www.supporteddecisionmaking.org/node/430 
WINGS MN is a Working Interdisciplinary Network of Guardianship Stakeholders, part of a national movement for improving guardianship and conservatorship practices, originally supported by grant funding from the National Guardianship Network, and currently supported by Elder Justice Grant funding from the Administration for Community Living. Our members include disability advocates, lawyers, judges, social service professionals, healthcare providers, guardians and conservators.  WINGS MN is convened by the Center for Excellence in Supported Decision Making, a program of Volunteers of America MN, in partnership with Lutheran Social Service of MN, MN Department of Human Services (Mental Health and Public Guardianship divisions), and the MN Elder Justice Center. 

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