COA - Council On Accreditation

	Adult Guardianship

Introduction

Administration and Management

Service Delivery Administration Standards

Service Standards

Definition

Adult Guardianship is the court-appointed responsibility of an agency to make any combination of informed personal and/or financial decisions on behalf of an individual who has been deemed incapacitated by the court. Decision-making authority is limited by the court order and must be carried out in accordance with state law.

Note: When it is determined that guardianship is necessary, the least restrictive form of guardianship should be chosen given the individual’s identified needs, strengths, and supports. Guardians are granted varying degrees of decision-making authority, which generally fall into one of two categories:

Guardian of the Person: The guardian is granted the authority to make decisions regarding personal matters such as medical, residential, and social service decisions.

Guardian of the Estate: The guardian is granted authority over the individual’s estate or finances.

Total authority to make personal and/or financial decisions on behalf of the individual is known as plenary guardianship; however, guardianship can be as limited as the court sees fit given the individual’s assessed capacity. Limited guardianship allows the court to grant decision making authority only over specific areas of the individual’s life, and is seen as the preferred form of guardianship as it maximizes his or her right to self-determination. For example, the guardian may have medical decision-making authority, but the individual retains his or her right to make housing decisions.

Note: Throughout this document, the term individual will be used to refer to the incapacitated person or ward for whom the agency is acting as guardian.

Note: Guardianship services are governed by state law and practice can vary dramatically from state to state. The standards below reflect practices that have been associated with improved client outcomes, but should be interpreted within the context of each state’s guardianship law.

Note: Please see Self-Paced_Training: Adult Guardianship (AG) in the Tools Index for additional assistance with this standard.

Research Note: The substituted-judgment standard of decision-making requires that the guardian attempt to accurately determine what the individual would have decided if he or she were competent to do so. Substituted judgment allows the guardian to make decisions on behalf of the individual based on the individual’s personal beliefs and definitions of well-being. However, it is not always possible to implement substituted judgment as sometimes individuals’ preferences could cause harm to themselves or others, their wishes are unknown, or state law or court order mandate a best-interest standard of decision-making. The best-interest standard requires that the guardian make an objective decision based on broadly held societal beliefs and definitions of well-being. The best-interest standard limits the individual’s right to self determination and is only recommended in cases where the individual has never had capacity to make independent decisions or when there is no reliable way to determine his or her wishes or values.


	PURPOSE: Individuals who receive guardianship services maintain a level of independence and self-determination appropriate to their functional capacity, and are at minimized risk of abuse, neglect, or exploitation.

RELATED FILES


	SERVICE One or more organization-operated programs or activities that have a common general objective and deploy the organization's material and human resources in a planned and systematic manner. An organization that publicly promotes or identifies itself in writing as offering a service, is licensed to deliver a service, assigns personnel and/or space to a service, or allocates financial resources to a service is considered to offer that service.


	PRACTICE Established actions or ways of proceeding in the regular performance of organizational duties. Policies and procedures often guide practice.


	OBJECTIVE A sub-goal stated in operational terms, i.e., a statement that makes clear what expected results are to be measured or assessed.


	CASE A general term used to designate clients (including individuals, families, and groups) served by an organization for purposes of monitoring the provision of services. A foster care case is generally based on the placement of an individual child, although casework for the child may include services to the child's family. A child protective services case is based on an entire family household if a family assessment model is used; otherwise a case is defined as a child.


	CLIENT See service recipient.